| Entity Name: | ALLIED HEALTH PROVIDER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Feb 2017 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 01 Nov 2023 (a year ago) |
| Document Number: | L17000044741 |
| FEI/EIN Number | 82-0660452 |
| Address: | 181 NE 43RD COURT, OAKLAND PARK, FL, 33334 |
| Mail Address: | 181 NE 43RD COURT, OAKLAND PARK, FL, 33334 |
| ZIP code: | 33334 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528557394 | 2018-05-07 | 2018-05-07 | 701 THREE ISLANDS BLVD STE 118, HALLANDALE BEACH, FL, 330092822, US | 1625 NE 3RD CT, FORT LAUDERDALE, FL, 333013808, US | |||||||||||||||||||||
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| Phone | +1 305-989-7291 |
Authorized person
| Name | DIANA MARTINEZ |
| Role | OWNER / PROVIDER |
| Phone | 3059897291 |
Taxonomy
| Taxonomy Code | 363A00000X - Physician Assistant |
| License Number | PA9105777 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI NUMBER |
| Number | 1811266216 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ DIANA P | Agent | 181 NE 43RD COURT, OAKLAND PARK, FL, 33334 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ DIANA P | Manager | 181 NE 43RD COURT, OAKLAND PARK, FL, 33334 |
| HOELSCHER WILLIAM | Manager | 181 NE 43RD COURT, OAKLAND PARK, FL, 33334 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-08 | 181 NE 43RD COURT, OAKLAND PARK, FL 33334 | No data |
| LC AMENDMENT | 2023-11-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| LC Amendment | 2023-11-01 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-05 |
| Florida Limited Liability | 2017-02-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
