| Entity Name: | EDEL ALVAREZ MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Mar 2021 (4 years ago) |
| Document Number: | L21000098025 |
| FEI/EIN Number | 86-2515998 |
| Mail Address: | 5512 18TH ST NE, ST PETERSBURG, FL 33703 |
| Address: | 2878 Roosevelt Blvd, Clearwater, FL 33760 |
| ZIP code: | 33760 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093393993 | 2021-03-31 | 2021-10-21 | 5512 18TH ST NE, ST PETERSBURG, FL, 337031731, US | 2878 ROOSEVELT BLVD, CLEARWATER, FL, 337601923, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 813-453-7931 |
| Phone | +1 727-474-3442 |
Authorized person
| Name | DR. EDEL ALVAREZ |
| Role | OWNER/PHYSICIAN |
| Phone | 7274743442 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ALVAREZ, EDEL | Agent | 2878 Roosevelt Blvd, Clearwater, FL 33760 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ, EDEL | Authorized Member | 5512 18TH ST NE, SAINT PETERSBURG, FL 33703 |
| Name | Role | Address |
|---|---|---|
| Lauren, Rebecca A | Authorized Representative | 5512 18TH ST NE, ST PETERSBURG, FL 33703 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000143829 | CASA CLINIC LLC | ACTIVE | 2022-11-18 | 2027-12-31 | No data | 5512 18TH ST NE, SAINT PETERSBURG, FL, 33703--173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-12 | 2878 Roosevelt Blvd, Clearwater, FL 33760 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-12-01 | 2878 Roosevelt Blvd, Clearwater, FL 33760 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-29 |
| Florida Limited Liability | 2021-03-01 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
