| Entity Name: | DENTIST IN PALM BEACH GARDENS, P.A |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Mar 2021 (4 years ago) |
| Document Number: | L21000128828 |
| FEI/EIN Number | 86-3845151 |
| Address: | 4489 MARINERS COVE DRIVE, WELLINGTON, FL, 33449, US |
| Mail Address: | 4489 MARINERS COVE DRIVE, WELLINGTON, FL, 33449, US |
| ZIP code: | 33449 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154087740 | 2021-11-09 | 2021-11-09 | 11903 SOUTHERN BLVD, STE #116, ROYAL PALM BEACH, FL, 33411, US | 3385 BURNS RD, #206, PALM BEACH GARDENS, FL, 33410, US | |||||||||||||||
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| Phone | +1 561-795-7668 |
| Fax | 5617714284 |
Authorized person
| Name | MR. NAREN SIRIVOLO |
| Role | OFFICE MANAGER |
| Phone | 5617957668 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| sirivolu kapil | Agent | 4489 MARINERS COVE DR, WELLINGTON, FL, 33449 |
| Name | Role | Address |
|---|---|---|
| SIRIVOLU SUNITHA | Manager | 4489 MARINERS COVE DR, WELLINGTON, FL, 33449 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000065860 | FAMILY DENTIST OF PALM BEACH | ACTIVE | 2021-05-13 | 2026-12-31 | No data | 3385 BURNS RD, STE 206, PALM BEACH GARDENS, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-16 | sirivolu, kapil | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-04-15 |
| Florida Limited Liability | 2021-03-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
