| Entity Name: | PARK PLACE MEDICAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 05 Nov 2020 (4 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: | L20000351314 |
| FEI/EIN Number | 85-3956039 |
| Address: | 1800 Pembrook Dr., Suite 300, ORLANDO, FL 32810 |
| Mail Address: | 1800 Pembrook Dr., Suite 300, ORLANDO, FL 32810 |
| ZIP code: | 32810 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063164226 | 2022-01-19 | 2022-01-19 | 1800 PEMBROOK DR STE 300, ORLANDO, FL, 328106378, US | 1800 PEMBROOK DR STE 300, ORLANDO, FL, 328106378, US | |||||||||||||||||||||
|
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| Phone | +1 407-712-0514 |
Authorized person
| Name | MS. EMMA ZAINABU SANDI |
| Role | CEO |
| Phone | 4077120514 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 251K00000X - Public Health or Welfare Agency |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SANDI, EMMA Z | Agent | 6865 long needle cy, ORLANDO, FL 32822 |
| Name | Role | Address |
|---|---|---|
| SANDI, EMMA Z | Authorized Member | 6865 long needle ct, ORLANDO, FL 32822 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-01-19 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-19 | 1800 Pembrook Dr., Suite 300, ORLANDO, FL 32810 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-19 | 6865 long needle cy, ORLANDO, FL 32822 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-19 | 1800 Pembrook Dr., Suite 300, ORLANDO, FL 32810 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-19 | SANDI, EMMA Z | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2022-01-19 |
| Florida Limited Liability | 2020-11-05 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
