| Entity Name: | MDLT PHYSICIAN SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Sep 2021 (3 years ago) |
| Document Number: | L21000392848 |
| FEI/EIN Number | 87-2482987 |
| Address: | 27327 SW 133RD CT, HOMESTEAD, FL, 33032 |
| Mail Address: | 27327 SW 133RD CT, HOMESTEAD, FL, 33032 |
| ZIP code: | 33032 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467139196 | 2023-07-04 | 2023-07-04 | 27327 SW 133RD CT, HOMESTEAD, FL, 330328582, US | 27327 SW 133RD CT, HOMESTEAD, FL, 330328582, US | |||||||||||||
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| Phone | +1 786-380-1538 |
Authorized person
| Name | MARIA EUGENIA DE LA TORRE |
| Role | AMBR |
| Phone | 7863801538 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DE LA TORRE MARIA E | Agent | 27327 SW 133RD CT, HOMESTEAD, FL, 33032 |
| Name | Role | Address |
|---|---|---|
| DE LA TORRE MARIA E | Authorized Member | 27327 SW 133RD CT, HOMESTEAD, FL, 33032 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-03-02 |
| Florida Limited Liability | 2021-09-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
