| Entity Name: | GD FL DDP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 May 2022 (3 years ago) |
| Document Number: | L22000220597 |
| FEI/EIN Number | 88-2527793 |
| Address: | 5803 NW 151ST STREET, SUITE 201, MIAMI LAKES, FL, 33014 |
| Mail Address: | 5803 NW 151ST STREET, SUITE 201, MIAMI LAKES, FL, 33014 |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003536459 | 2022-08-29 | 2022-08-29 | 10019 CLEARY BLVD, PLANTATION, FL, 333241000, US | 10019 CLEARY BLVD, PLANTATION, FL, 333241000, US | |||||||||||||
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| Phone | +1 954-473-6400 |
Authorized person
| Name | CHAD HENDRICKS |
| Role | CREDENTIALING |
| Phone | 6128590444 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CAPITOL CORPORATE SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| MOLINA ANTONIO | Member | 5803 NW 151ST STREET, SUITE 201, MIAMI LAKES, FL, 33014 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-20 |
| ANNUAL REPORT | 2023-04-28 |
| Florida Limited Liability | 2022-05-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
