| Entity Name: | FAMILY ORTHODONTICS OF FLORIDA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 May 2018 (7 years ago) |
| Document Number: | L18000113848 |
| FEI/EIN Number | 61-1892008 |
| Address: | 2970 Brandywine Road, Suite 200, Atlanta, GA, 30341, US |
| Mail Address: | 2970 Brandywine Road, Suite 200, Atlanta, GA, 30341, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487149290 | 2018-06-25 | 2018-06-25 | 1350 SPRING ST NW STE 600, ATLANTA, GA, 303092870, US | 2217 KINGSLEY AVE, ORANGE PARK, FL, 320735115, US | |||||||||||||
|
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| Phone | +1 770-692-1000 |
Authorized person
| Name | TAMONIA LEONARD |
| Role | CREDENTIALING SPECIALIST |
| Phone | 6782444844 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Martin Robert S | Member | 2970 Brandywine Road, Atlanta, GA, 30341 |
| Name | Role |
|---|---|
| D4C DENTAL BRANDS, INC. | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-17 | 2970 Brandywine Road, Suite 200, Atlanta, GA 30341 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-17 | 2970 Brandywine Road, Suite 200, Atlanta, GA 30341 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-05-11 |
| ANNUAL REPORT | 2019-03-20 |
| Florida Limited Liability | 2018-05-07 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
