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PALM HARBOR DENTAL GROUP, PLLC - Florida Company Profile

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Company Details

Entity Name: PALM HARBOR DENTAL GROUP, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

PALM HARBOR DENTAL GROUP, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 01 Mar 2023 (2 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 31 May 2023 (2 years ago)
Document Number: L23000094273
FEI/EIN Number 92-2687892

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 30685 US HWY 19 NORTH, PALM HARBOR, FL, 34684, US
Mail Address: 30685 US HWY 19 NORTH, PALM HARBOR, FL, 34684, US
ZIP code: 34684
City: Palm Harbor
County: Pinellas
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
ADUSUMILLI DIVVA Manager 30685 US HWY 19 NORTH, PALM HARBOR, FL, 34684
PHILOMIN ARVIND Manager 30685 US HWY 19 NORTH, PALM HARBOR, FL, 34684
KAPLAN KAREN Agent 11800 30TH COURT NORTH, ST. PETERSBURG, FL, 33716

National Provider Identifier

NPI Number:
1699554238
Certification Date:
2023-09-23

Authorized Person:

Name:
SHIRLEY BOCAS
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000116443 PALM HARBOR DENTAL ACTIVE 2023-09-20 2028-12-31 - 30685 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684
G23000078609 PALM HARBOR PREMIER DENTAL ACTIVE 2023-06-30 2028-12-31 - 30685 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-10-10 30685 US HWY 19 NORTH, PALM HARBOR, FL 34684 -
CHANGE OF MAILING ADDRESS 2023-10-10 30685 US HWY 19 NORTH, PALM HARBOR, FL 34684 -
LC AMENDMENT 2023-05-31 - -

Documents

Name Date
ANNUAL REPORT 2024-02-29
LC Amendment 2023-05-31
Florida Limited Liability 2023-03-01

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Date of last update: 02 Jul 2025

Sources: Florida Department of State