| Entity Name: | SUNKIDZ PEDIATRIC DENTISTRY GROUP PLANTATION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 28 Oct 2022 (2 years ago) |
| Document Number: | L22000464145 |
| FEI/EIN Number | 92-0857296 |
| Address: | 9675 W BROWARD BLVD, PLANTATION, FL 33324 |
| Mail Address: | 691 CARROTWOOD TERR, PLANTATION, FL 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497536221 | 2023-10-09 | 2023-10-09 | 691 CARROTWOOD TER, PLANTATION, FL, 333248223, US | 9675 W BROWARD BLVD, PLANTATION, FL, 333242321, US | |||||||||||||||||||
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| Phone | +1 305-310-6858 |
Authorized person
| Name | DR. RITA PATEL |
| Role | DENTIST AND OWNER |
| Phone | 3058005439 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 015581100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FELDMAN, PAUL | Agent | 691 CARROTWOOD TERRACE, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| FELDMAN, PAUL | Manager | 691 CARROTWOOD TERRACE, PLANTATION, FL 33324 |
| PATEL, RITA | Manager | 691 CARROTWOOD TERRACE, PLANTATION, FL 33324 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-09 |
| ANNUAL REPORT | 2023-03-14 |
| Florida Limited Liability | 2022-10-28 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
