| Entity Name: | FONORT LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 16 May 2018 (7 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L18000122252 |
| FEI/EIN Number | 83-0904055 |
| Address: | 129 MONTCLAIRE DRIVE, WESTON, FL 33326 |
| Mail Address: | 129 MONTCLAIRE DRIVE, WESTON, FL 33326 |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205398575 | 2019-04-04 | 2019-04-04 | 129 MONTCLAIRE DR, WESTON, FL, 333263587, US | 2300 N COMMERCE PKWY STE 113, WESTON, FL, 333263255, US | |||||||||||||||||||
|
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| Phone | +1 347-571-4429 |
Authorized person
| Name | NUBIA FONSECA ORTIZ |
| Role | INTERNAL MEDICINE |
| Phone | 3475714429 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004344400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FONSECA-ORTIZ, NUBIA | Agent | 129 MONTCLAIRE DRIVE, WESTON, FL 33326 |
| Name | Role | Address |
|---|---|---|
| FONSECA-ORTIZ, NUBIA | Manager | 129 MONTCLAIRE DRIVE, WESTON, FL 33326 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2020-02-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-03 | FONSECA-ORTIZ, NUBIA | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2020-02-03 |
| Florida Limited Liability | 2018-05-16 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
