| Entity Name: | NABE PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Jan 2021 (4 years ago) |
| Document Number: | L21000031692 |
| FEI/EIN Number | 86-3863768 |
| Address: | 906 W SUNRISE BLVD, SUITE B, FORT LAUDERDALE, FL, 33311 |
| Mail Address: | 8751 NW 157 TER., MIAMI LAKES, FL, 33018 |
| ZIP code: | 33311 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467026724 | 2021-05-19 | 2024-08-03 | 8751 NW 157TH TER, MIAMI LAKES, FL, 330181412, US | 906 W SUNRISE BLVD STE B, FORT LAUDERDALE, FL, 333117131, US | |||||||||||||||||||||||||||
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| Phone | +1 305-527-3189 |
| Fax | 9548270868 |
| Phone | +1 954-368-6626 |
Authorized person
| Name | GERALDO RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 9543686626 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PP048 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Rodriguez GERALDO | Agent | 906 W SUNRISE BLVD, FORT LAUDERDALE, FL, 33311 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ GERALDO | President | 906 W SUNRISE BLVD STE B, FORT LAUDERDALE, FL, 33311 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-02-21 | Rodriguez, GERALDO | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-02-21 |
| Florida Limited Liability | 2021-01-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
