| Entity Name: | FAVREAU DERMATOLOGY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 14 Apr 2017 (8 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L17000084518 |
| Address: | 201 SE 14TH ST, FORT LAUDERDALE, FL 33316 |
| Mail Address: | 201 SE 14TH ST, FORT LAUDERDALE, FL 33316 |
| ZIP code: | 33316 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982130985 | 2017-05-11 | 2017-05-11 | 201 SE 14TH ST, FORT LAUDERDALE, FL, 333161827, US | 201 SE 14TH ST, FORT LAUDERDALE, FL, 333161827, US | |||||||||||||||||
|
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| Phone | +1 954-457-4201 |
Authorized person
| Name | MR. MO TOLEDO |
| Role | AUTHORIZED OFFICIAL |
| Phone | 9544574201 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | OS9004 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| TRACY FAVREAU, D.O., P.A. | Agent |
| Name | Role |
|---|---|
| ALLURE REJUVENATION, LLC | Manager |
| TRACY FAVREAU, D.O., P.A. | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2017-04-14 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
