| Entity Name: | PREMIERCARDIA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Jan 2021 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Oct 2023 (a year ago) |
| Document Number: | L21000039994 |
| FEI/EIN Number | 35-2704890 |
| Address: | 215 HIGHWAY 17 S, EAST PALATKA, FL 32131 |
| Mail Address: | 215 HIGHWAY 17 S, EAST PALATKA, FL 32131 |
| ZIP code: | 32131 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265015416 | 2021-05-04 | 2024-05-24 | 5150 BELFORT RD BLDG 400, JACKSONVILLE, FL, 322566026, US | 213 S US HIGHWAY 17 STE A&B, EAST PALATKA, FL, 321314005, US | |||||||||||||||
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| Phone | +1 904-580-4730 |
| Fax | 9045804740 |
Authorized person
| Name | MORHAF IBRAHIM |
| Role | OWNER |
| Phone | 9045804730 |
Taxonomy
| Taxonomy Code | 207RC0001X - Clinical Cardiac Electrophysiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FASULO, STEPHANIE | Agent | 5150 BELFORT RD BLDG 400, JACKSONVILLE, FL 32256 |
| Name | Role | Address |
|---|---|---|
| IBRAHIM, MORHAF, DR. | Authorized Member | 5150 BELFORT RD BLDG 400, JACKSONVILLE, FL 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-10-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-10-05 | FASULO, STEPHANIE | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| REINSTATEMENT | 2023-10-05 |
| ANNUAL REPORT | 2022-04-27 |
| Florida Limited Liability | 2021-01-20 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
