| Entity Name: | ISAAC MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 May 2018 (7 years ago) |
| Document Number: | L18000131718 |
| FEI/EIN Number | 85-1895980 |
| Address: | 823 E HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| Mail Address: | 1381 SW 1ST STREET, BOCA RATON, FL 33486 |
| ZIP code: | 33441 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043809973 | 2021-01-14 | 2021-01-14 | 823 E HILLSBORO BLVD, DEERFIELD BEACH, FL, 334413521, US | 823 E HILLSBORO BLVD, DEERFIELD BEACH, FL, 334413521, US | |||||||||||||||||||
|
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| Phone | +1 561-467-0701 |
Authorized person
| Name | EMMANUEL ISAAC |
| Role | OWNER |
| Phone | 5615422234 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001255700 |
| State | FL |
| Name | Role |
|---|---|
| ISAAC AND EMMANUEL LLC | Agent |
| Name | Role | Address |
|---|---|---|
| ISAAC AND EMMANUEL LLC | Manager | No data |
| Rosaleine, Isaac J | Manager | 1381 SW 1st street, boca raton, FL 33486 |
| Name | Role |
|---|---|
| ISAAC AND EMMANUEL LLC | Chief Executive Officer |
| Name | Role |
|---|---|
| ISAAC AND EMMANUEL LLC | Authorized Member |
| Name | Role | Address |
|---|---|---|
| Rosaleine, Isaac J | Chief Operating Officer | 1381 SW 1st street, boca raton, FL 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-21 | 823 E HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-21 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-28 |
| ANNUAL REPORT | 2019-04-30 |
| Florida Limited Liability | 2018-05-25 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
