| Entity Name: | MARTIN N. ZAIAC, M.D., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Jul 2017 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 20 Nov 2023 (a year ago) |
| Document Number: | L17000143880 |
| FEI/EIN Number | 65-0464361 |
| Address: | 4308 Alton RD, #750, Miami, FL, 33140, US |
| Mail Address: | 11068 NW 3rd STreet, Coral SPrings, FL, 33071, US |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811939754 | 2006-06-12 | 2017-10-10 | 4308 ALTON RD, SUITE 750, MIAMI BEACH, FL, 331404556, US | 4308 ALTON RD, SUITE 750, MIAMI BEACH, FL, 331404556, US | |||||||||||||||||||||
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| Phone | +1 305-532-4478 |
| Fax | 3055329753 |
Authorized person
| Name | MRS. ONELIA VALDES |
| Role | OFFICE MANAGER |
| Phone | 3055324478 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 052392500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZAIAS-FAST MAGALY | Agent | 11068 N.W. 3RD ST., CORAL SPRINGS, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| Zaiac Martin NM.D. | Member | 11068 NW 3RD STREET, CORAL SPRINGS, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| Zaias-Fast Magaly | Manager | 11068 NW 3rd STreet, Coral SPrings, FL, 33071 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 4308 Alton RD, #750, Miami, FL 33140 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-30 | ZAIAS-FAST, MAGALY | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-24 | 4308 Alton RD, #750, Miami, FL 33140 | No data |
| LC AMENDMENT | 2023-11-20 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-11-20 | 11068 N.W. 3RD ST., CORAL SPRINGS, FL 33071 | No data |
| CONVERSION | 2017-07-03 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P94000011285. CONVERSION NUMBER 100000172731 |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2024-03-24 |
| LC Amendment | 2023-11-20 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-03-05 |
| ANNUAL REPORT | 2020-02-18 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-03-06 |
| Florida Limited Liability | 2017-07-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
