| Entity Name: | SPECIALITY AT PAUL G. PRESTE MD & ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 17 May 2018 (7 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L18000123738 |
| FEI/EIN Number | 83-0601035 |
| Address: | 3075 EAST COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308 |
| Mail Address: | 3075 EAST COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308 |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205316585 | 2018-08-16 | 2022-08-15 | 3075 E COMMERCIAL BLVD STE 1A, FORT LAUDERDALE, FL, 333084318, US | 3075 E COMMERCIAL BLVD, SUITE 1A, FORT LAUDERDALE, FL, 33308, US | |||||||||||||||||||||||||
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| Phone | +1 954-491-6200 |
| Fax | 9544916419 |
Authorized person
| Name | DONNA GOLDEN |
| Role | ADMINISTRATOR |
| Phone | 9544916200 |
Taxonomy
| Taxonomy Code | 207RR0500X - Rheumatology Physician |
| License Number | ME134189 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA BLUE PROVIDER ID |
| Number | K6RRB |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PRESTE, PAUL G, MD | Agent | 3075 EAST COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308 |
| Name | Role | Address |
|---|---|---|
| PRESTE, PAUL G, MD | Manager | 3075 EAST COMMERCIAL BLVD SUITE 1A, FORT LAUDERDALE, FL 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-04-10 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-06-27 |
| ANNUAL REPORT | 2019-02-15 |
| Florida Limited Liability | 2018-05-17 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
