| Entity Name: | ROSE DENTAL AT LAKEWOOD RANCH, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 21 Jan 2021 (4 years ago) |
| Document Number: | L21000042327 |
| FEI/EIN Number | 86-1922958 |
| Address: | 5561 BROADCAST COURT, LAKEWOOD RANCH, FL 34240 |
| Mail Address: | 4817 Ashton Rd, SARASOTA, FL 34233 |
| ZIP code: | 34240 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891468328 | 2021-07-29 | 2021-08-12 | 5561 BROADCAST CT, LAKEWOOD RANCH, FL, 342408472, US | 5561 BROADCAST CT, LAKEWOOD RANCH, FL, 342408472, US | |||||||||||||||||||||||
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| Phone | +1 561-309-6657 |
| Phone | +1 941-210-3975 |
| Fax | 9414877905 |
Authorized person
| Name | DR. ROSE HOANG LE |
| Role | OWNER |
| Phone | 9412103975 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1972916930 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LE, ROSE H | Agent | 5561 BROADCAST COURT, LAKEWOOD RANCH, FL 34240 |
| Name | Role | Address |
|---|---|---|
| LE, ROSE H | Manager | 5561 BROADCAST COURT, LAKEWOOD RANCH, FL 34240 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-07 | 5561 BROADCAST COURT, LAKEWOOD RANCH, FL 34240 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-07 | 5561 BROADCAST COURT, LAKEWOOD RANCH, FL 34240 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-09 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-04-29 |
| Florida Limited Liability | 2021-01-21 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
