| Entity Name: | ASSOCIATES IN INFECTIOUS DISEASES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Mar 2019 (6 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 08 Mar 2019 (6 years ago) |
| Document Number: | L19000059595 |
| FEI/EIN Number | 65-1055525 |
| Address: | 356 E MIDWAY ROAD, FT PIERCE, FL, 34982, US |
| Mail Address: | 356 E MIDWAY ROAD, FT PIERCE, FL, 34982, US |
| ZIP code: | 34982 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336156934 | 2006-08-03 | 2015-10-06 | 356 E MIDWAY RD, FORT PIERCE, FL, 349827148, US | 1801 SE HILLMOOR DR, STE C 207, PORT ST LUCIE, FL, 349527553, US | |||||||||||||||||||||||
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| Phone | +1 772-464-9746 |
| Phone | +1 772-335-4234 |
| Fax | 7723354236 |
Authorized person
| Name | MOTI RAMGOPAL |
| Role | CEO |
| Phone | 7724649746 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 260879900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GENTRY ANTONIA L | Agent | 745 SE PORT ST LUCIE, PORT ST LUCIE, FL, 34984 |
| Name | Role | Address |
|---|---|---|
| RAMGOPAL MOTI N | Manager | 356 E MIDWAY ROAD, FT PIERCE, FL, 34982 |
| COLLIN BERJAN | Manager | 356 E MIDWAY ROAD, FT PIERCE, FL, 34982 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2019-03-08 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P00000107337. CONVERSION NUMBER 300000190903 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-06 |
| ANNUAL REPORT | 2020-01-24 |
| Florida Limited Liability | 2019-03-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
