| Entity Name: | DHG PEDIATRICS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Mar 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 02 May 2023 (2 years ago) |
| Document Number: | L23000113626 |
| FEI/EIN Number | 922859123 |
| Address: | 3850 COCONUT CREEK PARKWAY, SUITE #1, COCONUT CREEK, FL, 33066, US |
| Mail Address: | 3850 COCONUT CREEK PARKWAY, SUITE # 3, COCONUT CREEK, FL, 33066, US |
| ZIP code: | 33066 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023719218 | 2023-03-14 | 2023-05-03 | 3850 COCONUT CREEK PKWY STE 1, COCONUT CREEK, FL, 330661600, US | 3850 COCONUT CREEK PKWY STE 1, COCONUT CREEK, FL, 330661600, US | |||||||||||||||
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| Phone | +1 954-746-7114 |
| Phone | +1 954-973-9222 |
Authorized person
| Name | JUAN BASTO |
| Role | OWNER |
| Phone | 9548171010 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MARTIN ALONSO ESQ | Agent | 3191 CORAL WAY, MIAMI, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| BASTO JUAN C | Authorized Member | 2900 NE 23RD PLACE, POMPANO BEACH, FL, 33062 |
| BASTO JONATHAN M | Authorized Member | 14910 SOUTHWEST 40TH STREET, DAVIE, FL, 33331 |
| BASTO NICHOLAS A | Authorized Member | 14321 PEDIGREE LANE, SOUTHWEST RANCHES, FL, 33330 |
| VAZQUEZ CHARLES | Authorized Member | 2900 NE 23RD PLACE, POMPANO BEACH, FL, 33062 |
| ROSA TOVAR JUAN E | Authorized Member | 6024 NORTHWEST 118TH DRIVE, CORAL SPRING, FL, 33076 |
| TOVAR CHAVEZ KAARRY C | Authorized Member | 4437 RAINBOW AVE, WESTON, FL, 33332 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-06-08 | 3850 COCONUT CREEK PARKWAY, SUITE #1, COCONUT CREEK, FL 33066 | No data |
| CHANGE OF MAILING ADDRESS | 2023-06-08 | 3850 COCONUT CREEK PARKWAY, SUITE #1, COCONUT CREEK, FL 33066 | No data |
| LC AMENDMENT | 2023-05-02 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| LC Amendment | 2023-05-02 |
| Florida Limited Liability | 2023-03-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
