| Entity Name: | ANTIDOTE AI LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Jul 2020 (5 years ago) |
| Document Number: | L20000202553 |
| FEI/EIN Number | 85-2127954 |
| Address: | 4960 SW 72nd Avenue, Suite 400, MIAMI, FL 33155 |
| Mail Address: | 4960 SW 72nd Avenue, Suite 400, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023753662 | 2022-04-28 | 2022-04-28 | 4960 SW 72ND AVE, MIAMI, FL, 331555544, US | 4960 SW 72ND AVE, MIAMI, FL, 331555544, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 865-592-7237 |
Authorized person
| Name | MR. ROY WILLIAM PRILLAMAN III |
| Role | OPERATIONS |
| Phone | 7865592723 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 207QA0401X - Addiction Medicine (Family Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QC1800X - Corporate Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 333300000X - Emergency Response System Companies |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Klein, Brent D | Agent | 3850 Bird Road, Suite 602, MIAMI, FL 33146 |
| Name | Role | Address |
|---|---|---|
| CAMPO, ALEXANDER | Manager | 4960 SW 72nd Avenue, MIAMI, FL 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-29 | 4960 SW 72nd Avenue, Suite 400, MIAMI, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-29 | 4960 SW 72nd Avenue, Suite 400, MIAMI, FL 33155 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-29 | Klein, Brent D | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-29 | 3850 Bird Road, Suite 602, MIAMI, FL 33146 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-06-30 |
| Florida Limited Liability | 2020-07-14 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
