| Entity Name: | MIAMI DERMATOLOGY AND MOHS SURGERY PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Apr 2022 (3 years ago) |
| Document Number: | L22000175885 |
| FEI/EIN Number | 88-2047486 |
| Address: | 4770 Biscayne Blvd, Ste 900, Miami, FL, 33137, US |
| Mail Address: | 4770 Biscayne Blvd, Ste 900, Miami, FL, 33137, US |
| ZIP code: | 33137 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891430336 | 2022-04-29 | 2023-11-07 | 4770 BISCAYNE BLVD, STE 900, MIAMI, FL, 331373202, US | 4770 BISCAYNE BLVD, STE 900, MIAMI, FL, 331373202, US | |||||||||||||||||||||||
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| Phone | +1 269-271-1410 |
| Fax | 3054046367 |
Authorized person
| Name | MIESHA MERATI |
| Role | OWNER |
| Phone | 2692711410 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | Yes |
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Mohammad Hassan | Agent | 710 W 27TH ST, Hialeah, FL, 33010 |
| Name | Role | Address |
|---|---|---|
| MERATI MIESHA | Manager | 710 W 27TH ST, HIALEAH, FL, 33010 |
| EZALDEIN HARIB | Manager | 710 W 27TH ST, HIALEAH, FL, 33010 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-02 | 4770 Biscayne Blvd, Ste 900, Miami, FL 33137 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-02 | 4770 Biscayne Blvd, Ste 900, Miami, FL 33137 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-02-02 | Mohammad, Hassan | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-02 | 710 W 27TH ST, Hialeah, FL 33010 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-14 |
| Florida Limited Liability | 2022-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
