| Entity Name: | PREVENT RX 2, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Sep 2019 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 18 Nov 2019 (5 years ago) |
| Document Number: | L19000236046 |
| FEI/EIN Number | 84-3193984 |
| Address: | 3677 Central Ave, Fort Meyers, FL, 33901, US |
| Mail Address: | 13079 nw 23 st, Pembroke Pines, FL, 33028, US |
| ZIP code: | 33901 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265065783 | 2020-02-13 | 2024-08-03 | 2275 ANTILA AVE, DAVIE, FL, 333246315, US | 3677 CENTRAL AVE STE A, FORT MYERS, FL, 339018226, US | |||||||||||||||||||||||||
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| Phone | +1 239-243-9025 |
| Fax | 8774709723 |
Authorized person
| Name | EDWIN RODRIGUEZ |
| Role | OWNER |
| Phone | 3057616907 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PG715 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ EDWIN | Agent | 906 W SUNRISE BLVD, ,, FORT LAUDERDALE, FL, 33311 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ EDWIN | Manager | 906 W SUNRISE BLVD,, FORT LAUDERDALE, FL, 33311 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000018340 | PREVENT RX | ACTIVE | 2021-02-06 | 2026-12-31 | No data | 3677 CENTRAL AVE SUITE A, FORT MEYERS, FL, 33901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-24 | 3677 Central Ave, A, Fort Meyers, FL 33901 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-24 | 3677 Central Ave, A, Fort Meyers, FL 33901 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-23 | RODRIGUEZ, EDWIN | No data |
| LC AMENDMENT | 2019-11-18 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-05-02 |
| ANNUAL REPORT | 2021-01-15 |
| AMENDED ANNUAL REPORT | 2020-04-24 |
| ANNUAL REPORT | 2020-04-23 |
| LC Amendment | 2019-11-18 |
| Florida Limited Liability | 2019-09-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
