| Entity Name: | BONITA BEACH MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Jan 2021 (4 years ago) |
| Last Event: | LC DISSOCIATION MEM |
| Event Date Filed: | 19 Dec 2022 (2 years ago) |
| Document Number: | L21000043669 |
| FEI/EIN Number | 86-1625750 |
| Address: | 3421 BONITA BEACH ROAD, BONITA SPRINGS, FL, 34134, US |
| Mail Address: | 3421 BONITA BEACH ROAD, BONITA SPRINGS, FL, 34134, US |
| ZIP code: | 34134 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255921318 | 2021-01-22 | 2021-01-22 | 3431 BONITA BEACH RD UNIT 406, BONITA SPRINGS, FL, 341344153, US | 3431 BONITA BEACH RD UNIT 406, BONITA SPRINGS, FL, 341344153, US | |||||||||||||||
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| Phone | +1 239-888-9818 |
| Fax | 2393260467 |
Authorized person
| Name | BOGDAN-GABRIEL COZMUTA |
| Role | MANAGER |
| Phone | 2035580836 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GIRALDO SANDRA | Agent | 2098 SATSUMA LANE, NAPLES, FL, 34120 |
| Name | Role | Address |
|---|---|---|
| COZMUTA BOGDAN-GABRIEL | Manager | 3421 BONITA BEACH ROAD, BONITA SPRINGS, FL, 34134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC DISSOCIATION MEM | 2022-12-19 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-29 | 3421 BONITA BEACH ROAD, 406, BONITA SPRINGS, FL 34134 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-29 | 3421 BONITA BEACH ROAD, 406, BONITA SPRINGS, FL 34134 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-05-01 |
| CORLCDSMEM | 2022-12-19 |
| ANNUAL REPORT | 2022-04-29 |
| Florida Limited Liability | 2021-01-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
