| Entity Name: | MARK K. NAGRANI MD PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Sep 2022 (2 years ago) |
| Document Number: | L22000407033 |
| FEI/EIN Number | 92-0480698 |
| Address: | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 |
| Mail Address: | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 |
| ZIP code: | 32168 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154027852 | 2023-02-03 | 2023-02-03 | 612 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687327, US | 612 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687327, US | |||||||||||||||||||
|
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| Phone | +1 386-423-5500 |
| Fax | 8008139164 |
Authorized person
| Name | HART MEYRICH |
| Role | BUSINESS MANAGER |
| Phone | 4073409039 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NAGRANI, MARK A | Agent | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 |
| Name | Role | Address |
|---|---|---|
| NAGRANI, MARK K | Manager | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 |
| Name | Role | Address |
|---|---|---|
| NAGRANI, MARK A | Member | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000013265 | WATERSIDE WELLNESS | ACTIVE | 2023-01-26 | 2028-12-31 | No data | 2473 PALMETTO CIRCLE, DAYTONA BEACH, FL, 32119 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-28 | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-28 | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-28 | 612 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-02-28 |
| Florida Limited Liability | 2022-09-19 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
