| Entity Name: | ATTESOR MSO LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 May 2018 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 22 Jan 2019 (6 years ago) |
| Document Number: | L18000118974 |
| FEI/EIN Number | 830552930 |
| Address: | 3440 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021, US |
| Mail Address: | PO BOX 5137, HOLLYWOOD, FL, 33083, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851943591 | 2019-07-12 | 2020-08-13 | 3350 SW 148TH AVE STE 146, MIRAMAR, FL, 330273257, US | 3350 SW 148TH AVE STE 146, MIRAMAR, FL, 330273257, US | |||||||||||||||
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| Phone | +1 954-237-4377 |
| Fax | 8666531953 |
Authorized person
| Name | MR. THEOTIS V WILLIAMS |
| Role | CEO |
| Phone | 9542374412 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ATTESOR MSO LLC 401K | 2023 | 830552930 | 2024-07-11 | ATTESOR MSO LLC | 4 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-11 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| WILLIAMS THEOTIS | Agent | 3440 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS THEOTIS | President | PO BOX 5137, HOLLYWOOD, FL, 33083 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-29 | 3440 HOLLYWOOD BLVD, SUITE 415, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-29 | 3440 HOLLYWOOD BLVD, SUITE 415, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-29 | 3440 HOLLYWOOD BLVD, SUITE 415, HOLLYWOOD, FL 33021 | No data |
| LC AMENDMENT | 2019-01-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-01-22 | WILLIAMS, THEOTIS | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-30 |
| LC Amendment | 2019-01-22 |
| Florida Limited Liability | 2018-05-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
