| Entity Name: | NSI BROWARD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 May 2018 (7 years ago) |
| Document Number: | L18000134803 |
| FEI/EIN Number | 83-0741450 |
| Address: | 55 Weston RD., Sunrise, FL, 33326, US |
| Mail Address: | 55 Weston RD., Sunrise, FL, 33326, US |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295203784 | 2018-11-02 | 2023-08-02 | 55 WESTON RD STE 101B, WESTON, FL, 333261112, US | 55 WESTON RD STE 101B, WESTON, FL, 333261112, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-659-1208 |
| Fax | 9549606355 |
Authorized person
| Name | DARRAN HAMM |
| Role | OWNER |
| Phone | 9544000479 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE OF FLORIDA |
| Number | CH11011 |
| State | FL |
| Issuer | STATE OF FLORIDA |
| Number | ME124453 |
| State | FL |
| Issuer | STATE OF FLORIDA |
| Number | OS11815 |
| State | FL |
| Issuer | STATE OF FLORIDA |
| Number | PA9104903 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAMM DARRAN | Agent | 55 Weston RD., Sunrise, FL, 33326 |
| Name | Role | Address |
|---|---|---|
| HAMM DARRAN | Manager | 55 Weston RD., Sunrise, FL, 33326 |
| Name | Role | Address |
|---|---|---|
| MERCADO A | Authorized Person | 55 Weston RD., Weston, FL, 33326 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-29 | 55 Weston RD., Suite 101, Sunrise, FL 33326 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-29 | 55 Weston RD., Suite 101, Sunrise, FL 33326 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-29 | 55 Weston RD., Suite 101, Sunrise, FL 33326 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-03-01 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-03-13 |
| Florida Limited Liability | 2018-05-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
