| Entity Name: | ALLIED SURGICAL OF SOUTH FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 May 2018 (7 years ago) |
| Document Number: | L18000125197 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 7201 N. University Dr, Tamarac, FL, 33321, US |
| Mail Address: | 4823 NW 91st WAY, CORAL SPRINGS, FL, 33067, US |
| ZIP code: | 33321 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578041208 | 2018-08-03 | 2020-04-02 | 3255 NW 94TH AVE UNIT 8154, CORAL SPRINGS, FL, 330752009, US | 7201 N UNIVERSITY DR, TAMARAC, FL, 333212913, US | |||||||||||||||||
|
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| Phone | +1 954-854-0628 |
Authorized person
| Name | STORM ESTELLE |
| Role | OWNER/AMBR |
| Phone | 9548540628 |
Taxonomy
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| License Number | PA9102746 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ESTELLE STORM A | Agent | 4823 NW 91st WAY, CORAL SPRINGS, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| ESTELLE STORM A | Manager | 4823 NW 91st WAY, CORAL SPRINGS, FL, 33067 |
| PONTI CARLO | Manager | 4823 NW 91st Way, CORAL SPRINGS, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| ESTELLE STORM A | Authorized Member | 4823 NW 91st WAY, CORAL SPRINGS, FL, 33067 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000004960 | AGELESS REFLECTION MEDISPA | ACTIVE | 2020-01-10 | 2025-12-31 | No data | 4823 NW 91ST WAY, CORAL SPRINGS, FL, 33067 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-12 | 7201 N. University Dr, Tamarac, FL 33321 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-12 | 7201 N. University Dr, Tamarac, FL 33321 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-12 | 4823 NW 91st WAY, CORAL SPRINGS, FL 33067 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-16 |
| ANNUAL REPORT | 2023-03-12 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-06-24 |
| ANNUAL REPORT | 2019-04-04 |
| Florida Limited Liability | 2018-05-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
