MODERN UROLOGY GROUP, LLC - Florida Company Profile

Key Officers & Management

Name	Role	Address
VILARO JOSE	Manager	13025 SW 62ND AVENUE, PINECREST, FL, 33156
DE FAZIO ADAM	Manager	825 ALMERIA AVENUE, CORAL GABLES, FL, 33134
De Fazio Adam	Agent	3400 CORAL WAY, MIAMI, FL, 33145

National Provider Identifier

Authorized Person:

Taxonomy:

Contacts:

Form 5500 Series

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G22000029702	MODERN UROLOGY	ACTIVE	2022-03-07	2027-12-31	-	13025 SW 62ND AVE, PINECREST, FL, 33156

Events

Event Type	Filed Date	Value	Description
REGISTERED AGENT NAME CHANGED	2023-04-17	De Fazio, Adam	-
REGISTERED AGENT ADDRESS CHANGED	2023-04-17	3400 CORAL WAY, SUITE 500, MIAMI, FL 33145	-
CHANGE OF PRINCIPAL ADDRESS	2022-07-26	3400 CORAL WAY, SUITE 500, MIAMI, FL 33145	-
CHANGE OF MAILING ADDRESS	2022-07-26	3400 CORAL WAY, SUITE 500, MIAMI, FL 33145	-

Documents

Name	Date
ANNUAL REPORT	2024-03-18
ANNUAL REPORT	2023-04-17
Florida Limited Liability	2022-02-15