| Entity Name: | TOPAZ PEDIATRICS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 17 Jun 2020 (5 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L20000168397 |
| FEI/EIN Number | 85-1836611 |
| Address: | 2513 E SEMORAN BLVD., APOPKA, FL 32703 |
| Mail Address: | 2513 E SEMORAN BLVD., APOPKA, FL 32703 |
| ZIP code: | 32703 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073123931 | 2020-08-05 | 2020-08-05 | 2513 E SEMORAN BLVD, APOPKA, FL, 327035835, US | 2513 E SEMORAN BLVD, APOPKA, FL, 327035835, US | |||||||||||||||||||
|
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| Phone | +1 407-703-4342 |
Authorized person
| Name | MRS. KARLA FRANCISCO |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 4077034342 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 799463 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GUZMAN, MARJORIE K | Agent | 2513 E. SEMORAN BLVD., APOPKA, FL 32703 |
| Name | Role | Address |
|---|---|---|
| FRANCISCO, KARLA Z | Authorized Representative | 2513 E. SEMORAN BLVD., APOPKA, FL 32703 |
| Name | Role | Address |
|---|---|---|
| Guzman, Marjorie | Chief Executive Officer | 2513 E SEMORAN BLVD., APOPKA, FL 32703 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-02-12 |
| Florida Limited Liability | 2020-06-17 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
