| Entity Name: | SUPPORTIVE MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SUPPORTIVE MD LLC 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: | 18 Mar 2022 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 06 Jun 2024 (9 months ago) |
| Document Number: | L22000112609 |
| FEI/EIN Number |
88-1334245
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 11117 REGATTA LANE, WELLINGTON, FL, 33449 |
| Mail Address: | 11117 REGATTA LANE, WELLINGTON, FL, 33449 |
| ZIP code: | 33449 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427882356 | 2024-09-02 | 2024-09-02 | 11117 REGATTA LN, WELLINGTON, FL, 334497416, US | 11117 REGATTA LN, WELLINGTON, FL, 334497416, US | |||||||||||||||||
|
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| Phone | +1 626-389-7410 |
Authorized person
| Name | DR. SUFANA A AL KHUNAIZI |
| Role | MD |
| Phone | 6263897410 |
Taxonomy
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AL KHUNAIZI SUFANA | Member | 11117 REGATTA LANE, WELLINGTON, FL, 33449 |
| MALIK SHABAN | Agent | 5300 W HILLSBORO BLVD, COCONUT CREEK, FL, 33073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-06-06 | - | - |
| REGISTERED AGENT NAME CHANGED | 2024-06-06 | MALIK, SHABAN | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-06-06 | 5300 W HILLSBORO BLVD, SUITE 218, COCONUT CREEK, FL 33073 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-06-06 |
| Florida Limited Liability | 2022-03-18 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
