| Entity Name: | MD-PRP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L22000415448 |
| FEI/EIN Number | 92-0494766 |
| Address: | 11319 65th Terrace E, Palmetto, FL 34221 |
| Mail Address: | 11319 65th Terrace E, Palmetto, FL 34221 |
| ZIP code: | 34221 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548048374 | 2023-09-21 | 2024-06-11 | 4020 SAWYER RD, SARASOTA, FL, 342331272, US | 4020 SAWYER RD, SARASOTA, FL, 342331272, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 717-350-4254 |
Authorized person
| Name | MENA AYOUB |
| Role | OWNER |
| Phone | 7173504254 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AYOUB, MENA | Agent | 107 SEA HORSE DRIVE SOUTHEAST, UNIT A, ST. PETERSBURG, FL 33705 |
| Name | Role | Address |
|---|---|---|
| AYOUB, MENA | Authorized Member | 11319 65TH TERRACE EAST, PALMETTO, FL 34221 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-06 | 11319 65th Terrace E, Palmetto, FL 34221 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-06 | 11319 65th Terrace E, Palmetto, FL 34221 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-12 | 107 Sea Horse Drive Southeast, Unit A, St. Petersburg, FL 33705 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-12 | 107 Sea Horse Drive Southeast, Unit A, St. Petersburg, FL 33705 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| ANNUAL REPORT | 2023-06-19 |
| Florida Limited Liability | 2022-09-23 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
