| Entity Name: | TRIDENT ANTI AGING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Company
TRIDENT ANTI AGING LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 26 May 2017 (8 years ago) |
| Document Number: | L17000116882 |
| FEI/EIN Number |
82-1763329
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 800 E BROWARD BLVD, Suite 410, FT LAUDERDALE, FL 33301 |
| Mail Address: | 800 E BROWARD BLVD, Suite 410, FT LAUDERDALE, FL 33301 |
| ZIP code: | 33301 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023574696 | 2019-02-19 | 2019-08-26 | 800 E BROWARD BLVD STE 400, FORT LAUDERDALE, FL, 333012033, US | 800 E BROWARD BLVD STE 400, FORT LAUDERDALE, FL, 333012033, US | |||||||||||||||||||||||||
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| Phone | +1 954-451-5454 |
Authorized person
| Name | JOHN POULOS |
| Role | OWNER |
| Phone | 9544515454 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1750407086 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1750716387 |
| State | GA |
| Name | Role | Address |
|---|---|---|
| Poulos, John J | Agent | 800 E BROWARD BLVD, 410, FT LAUDERDALE, FL 33301 |
| JJPOULOS HOLDINGS LLC | Manager | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000023239 | TRIDENT PRIMARY & PREVENTATIVE CARE | EXPIRED | 2019-02-15 | 2024-12-31 | - | 800 EAST BROWARD BLVD, SUITE 400, FT LAUDERDALE, FL, 33301 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-13 | 800 E BROWARD BLVD, 410, FT LAUDERDALE, FL 33301 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2023-09-15 | 800 E BROWARD BLVD, Suite 410, FT LAUDERDALE, FL 33301 | - |
| CHANGE OF MAILING ADDRESS | 2023-09-15 | 800 E BROWARD BLVD, Suite 410, FT LAUDERDALE, FL 33301 | - |
| REGISTERED AGENT NAME CHANGED | 2019-04-01 | Poulos, John J | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-22 |
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-05-16 |
| ANNUAL REPORT | 2019-04-01 |
| AMENDED ANNUAL REPORT | 2018-10-29 |
| ANNUAL REPORT | 2018-03-03 |
| Florida Limited Liability | 2017-05-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4725567701 | 2020-05-01 | 0455 | PPP | 800 EAST BROWARD BLVD SUITE 400, FORT LAUDERDALE, FL, 33301 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 18 Feb 2025
Sources: Florida Department of State
