| Entity Name: | GREENBROOK MEDICAL PRACTICE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
GREENBROOK MEDICAL PRACTICE, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 10 Aug 2021 (4 years ago) |
| Document Number: | L21000360069 |
| FEI/EIN Number |
87-2125101
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 11200 E Dr Martin Luther King Jr Blvd, Suite 107, Seffner, FL, 33584, US |
| Mail Address: | 11200 E Dr Martin Luther King Jr Blvd, Suite 107, Seffner, FL, 33584, US |
| ZIP code: | 33584 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457014342 | 2021-10-18 | 2023-08-09 | 11200 E DR MARTIN LUTHER KING JR BLVD STE 107, SEFFNER, FL, 335848351, US | 11200 E DR MARTIN LUTHER KING JR BLVD STE 107, SEFFNER, FL, 335848351, US | |||||||||||||||||
|
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| Phone | +1 813-443-3399 |
Authorized person
| Name | RAJ MACHHAR |
| Role | CHIEF MEDICAL OFFICER |
| Phone | 8134433399 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MACHHAR RAJ M.D. | Agent | 6811 FLORIDA HIGHWAY 54 WEST, NEW PORT RICHEY, FL, 34653 |
| MACHHAR RAJ M.D. | Manager | 3404 S Beach Drive, Tampa, FL, 33629 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-17 | 11200 E Dr Martin Luther King Jr Blvd, Suite 107, Seffner, FL 33584 | - |
| CHANGE OF MAILING ADDRESS | 2022-03-17 | 11200 E Dr Martin Luther King Jr Blvd, Suite 107, Seffner, FL 33584 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-18 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-17 |
| Florida Limited Liability | 2021-08-10 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
