| Entity Name: | BON SALUT ORGANIC MED SPA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 27 Mar 2017 (8 years ago) |
| Date of dissolution: | 16 Feb 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 16 Feb 2022 (3 years ago) |
| Document Number: | L17000069387 |
| FEI/EIN Number | 82-0869004 |
| Address: | 14846 TAMIAMI TRAIL, NORTH PORT, FL 34287 |
| Mail Address: | 14846 TAMIAMI TRAIL, NORTH PORT, FL 34287 |
| ZIP code: | 34287 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972156289 | 2019-07-17 | 2019-07-22 | 14846 TAMIAMI TRL, NORTH PORT, FL, 342872701, US | 14846 TAMIAMI TRL, NORTH PORT, FL, 342872701, US | |||||||||||||||||||
|
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| Phone | +1 941-876-3577 |
Authorized person
| Name | MRS. ANNE MARIE FARAG |
| Role | DIRECTOR OWNER |
| Phone | 7276929465 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1003885815 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FARAG, ANNE MARIE L | Agent | 14846 TAMIAMI TRAIL, NORTH PORT, FL 34287 |
| Name | Role | Address |
|---|---|---|
| FARAG, ANNE MARIE L | Manager | 14800 TAMIAMI TRAIL B104, NORTH PORT, FL 34287 UN |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-02-16 | No data | No data |
| LC AMENDMENT | 2017-10-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-10-20 | 14846 TAMIAMI TRAIL, NORTH PORT, FL 34287 | No data |
| CHANGE OF MAILING ADDRESS | 2017-10-20 | 14846 TAMIAMI TRAIL, NORTH PORT, FL 34287 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-10-20 | FARAG, ANNE MARIE L | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-02-16 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-05-29 |
| ANNUAL REPORT | 2018-05-31 |
| LC Amendment | 2017-10-20 |
| Florida Limited Liability | 2017-03-27 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
