| Entity Name: | CCG PALLIATIVE CARE SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 08 Nov 2017 (7 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L17000230891 |
| FEI/EIN Number | 82-3387718 |
| Address: | 8251 W BROWARD BLVD, STE 103, PLANTATION, FL 33324 |
| Mail Address: | 8251 W BROWARD BLVD, STE 103, PLANTATION, FL 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811401805 | 2017-11-29 | 2018-03-17 | 8251 W BROWARD BLVD STE 103, PLANTATION, FL, 333242703, US | 8251 W BROWARD BLVD STE 103, PLANTATION, FL, 333242703, US | |||||||||||||||||||
|
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| Phone | +1 954-255-7310 |
| Fax | 9542557311 |
Authorized person
| Name | DR. MARIO B PEREIRA |
| Role | MD |
| Phone | 9542557310 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME104716 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| ME & ASSOCIATES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| SIERRA ALPHA MEDICAL, PA | Authorized Member | 8251 W BROWARD BLVD, STE 103, PLANTATION, FL 33324 |
| ALHOMSI, PA | Authorized Member | 8251 W BROWARD BLVD, STE 103, PLANTATION, FL 33324 |
| TREMBITA, PA | Authorized Member | 8251 W BROWARD BLVD, STE 103, PLANTATION, FL 33324 |
| M & L OF SOUTH FLORIDA, LLC | Authorized Member | 8251 W BROWARD BLVD, STE 103, PLANTATION, FL 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-01-08 |
| Florida Limited Liability | 2017-11-08 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
