| Entity Name: | SUPERIOR PHYSICIAN GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 May 2018 (7 years ago) |
| Date of dissolution: | 29 Mar 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Mar 2022 (3 years ago) |
| Document Number: | L18000118880 |
| FEI/EIN Number | 830575727 |
| Address: | 6983 East Fowler Ave, TEMPLE TERRACE, FL, 33617, US |
| Mail Address: | 10730 N 56TH., SUITE 209, TEMPLE TERRACE, FL, 33617, US |
| ZIP code: | 33617 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164912754 | 2018-05-18 | 2018-05-22 | 10730 N 56TH ST STE 209, TEMPLE TERRACE, FL, 336173611, US | 10730 N 56TH ST STE 209, TEMPLE TERRACE, FL, 33617, US | |||||||||||||||||
|
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| Phone | +1 813-365-5680 |
Authorized person
| Name | MS. RENII MODISETTE |
| Role | OPERATIONS MANAGER |
| Phone | 8133655680 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SAED AYMAN B | Agent | 10730 N 56TH., TEMPLE TERRACE, FL, 33617 |
| Name | Role | Address |
|---|---|---|
| SAED AYMAN B | Manager | 10730 N 56TH., SUITE 209, FL, 33617 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-10-20 | 6983 East Fowler Ave, TEMPLE TERRACE, FL 33617 | No data |
| VOLUNTARY DISSOLUTION | 2022-03-29 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-03-29 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-13 |
| Florida Limited Liability | 2018-05-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
