| Entity Name: | SOUTH FLORIDA CANCER INSTITUTE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Jan 2018 (7 years ago) |
| Document Number: | L18000005309 |
| FEI/EIN Number | 82-3951221 |
| Address: | 1005 MARINA MILE BLVD, SUITE 515, FORT LAUDERDALE, FL 33315 |
| Mail Address: | 1005 MARINA MILE BLVD, SUITE #515, FORT LAUDERDALE, FL 33315 |
| ZIP code: | 33315 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790287878 | 2018-03-05 | 2020-03-25 | 1005 MARINA MILE BLVD, FORT LAUDERDALE, FL, 333152433, US | 1005 MARINA MILE BLVD, FORT LAUDERDALE, FL, 333152433, US | |||||||||||||||||||||||||
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| Phone | +1 954-658-6439 |
Authorized person
| Name | DR. ALIA ABDULLA |
| Role | MEDICAL DIRECTOR |
| Phone | 9544654693 |
Taxonomy
| Taxonomy Code | 207RX0202X - Medical Oncology Physician |
| Is Primary | No |
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 2086X0206X - Surgical Oncology Physician |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ABDULLA, ALIA | Agent | 1005 MARINA MILE BLVD, SUITE #515, FORT LAUDERDALE, FL 33315 |
| Name | Role | Address |
|---|---|---|
| ABDULLA, ALIA | DR. | 1005 MARINA MILE BLVD, SUITE #515, FORT LAUDERDALE, FL 33315 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-03-26 |
| ANNUAL REPORT | 2022-04-16 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-01-04 |
| Florida Limited Liability | 2018-01-05 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
