| Entity Name: | PENSTAR PROVIDER NETWORK LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 26 May 2020 (5 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L20000142801 |
| FEI/EIN Number | 85-1880087 |
| Address: | 1931 NW 150 AVE, SUITE 228, PEMBROKE PINES, FL, 33028, US |
| Mail Address: | 1931 NW 150th Ave, 228, Pembroke Pines, FL, 33028, US |
| ZIP code: | 33028 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912509233 | 2020-11-11 | 2020-11-11 | 1931 NW 150TH AVE STE 228, PEMBROKE PINES, FL, 330282880, US | 1931 NW 150TH AVE STE 228, PEMBROKE PINES, FL, 330282880, US | |||||||||||||
|
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| Phone | +1 754-226-6456 |
Authorized person
| Name | ILEANA VILLARREAL |
| Role | MGR |
| Phone | 9542815022 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Villarreal Ileana | Agent | 1931 NW 150th Ave, Pembroke Pines, FL, 33028 |
| Name | Role | Address |
|---|---|---|
| Villarreal Ileana | Manager | 1931 NW 150th Ave, Pembroke Pines, FL, 33028 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-10 | 1931 NW 150th Ave, 228, Pembroke Pines, FL 33028 | No data |
| REINSTATEMENT | 2021-11-10 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-11-10 | 1931 NW 150 AVE, SUITE 228, PEMBROKE PINES, FL 33028 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-11-10 | Villarreal, Ileana | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-12-28 | 1931 NW 150 AVE, SUITE 228, PEMBROKE PINES, FL 33028 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2021-11-10 |
| Florida Limited Liability | 2020-05-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
