| Entity Name: | INTEGRATED SPECIALTY ALLIANCE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Feb 2022 (3 years ago) |
| Document Number: | L22000088206 |
| FEI/EIN Number | 88-0673489 |
| Address: | 14400 NW 77th Court, Suite 301, Miami Lakes, FL 33016 |
| Mail Address: | 14400 NW 77th Court, Suite 301, Miami Lakes, FL 33016 |
| ZIP code: | 33016 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548035322 | 2023-11-21 | 2023-11-21 | 8875 NW 23RD ST, DORAL, FL, 331722419, US | 8875 NW 23RD ST, DORAL, FL, 331722419, US | |||||||||||||||
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| Phone | +1 770-810-3796 |
| Fax | 7708103789 |
Authorized person
| Name | DEBBIE SHUMAKE |
| Role | COO |
| Phone | 7708103796 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MATZNER, GARY C | Agent | 2800 PONCE DE LEON BLVD S1100, CORAL GABLES, FL 33134 |
| Name | Role | Address |
|---|---|---|
| NEDD, KESTER J | Manager | 14400 NW 77th Court, Suite 301 Miami Lakes, FL 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-07-11 | 14400 NW 77th Court, Suite 301, Miami Lakes, FL 33016 | No data |
| CHANGE OF MAILING ADDRESS | 2024-07-11 | 14400 NW 77th Court, Suite 301, Miami Lakes, FL 33016 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-11 |
| ANNUAL REPORT | 2023-04-06 |
| Florida Limited Liability | 2022-02-14 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
