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MUNROE MEDICAL PROVIDER, PLLC - Florida Company Profile

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Company Details

Entity Name: MUNROE MEDICAL PROVIDER, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 20 Mar 2023 (2 years ago)
Document Number: L23000160799
FEI/EIN Number 92-3867783
Address: 1995 BRIDGEWATER DRIVE, LAKE MARY, FL, 32746
Mail Address: 1995 BRIDGEWATER DRIVE, LAKE MARY, FL, 32746
ZIP code: 32746
City: Lake Mary
County: Seminole
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
VERMA BISHNU P President 1995 BRIDGEWATER DRIVE, LAKE MARY, FL, 32746
VERMA ANITA Treasurer 1995 BRIDGEWATER DRIVE, LAKE MARY, FL, 32746
VERMA BISHNU PDR. Agent 1995 BRIDGEWATER DRIVE, LAKE MARY, FL, 32746
VERMA ANITA Secretary 1995 BRIDGEWATER DRIVE, LAKE MARY, FL, 32746

National Provider Identifier

NPI Number:
1588358857
Certification Date:
2023-06-08

Authorized Person:

Name:
BISHNU PRAKASH VERMA
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3868607216

Documents

Name Date
ANNUAL REPORT 2024-02-06
Florida Limited Liability 2023-03-20

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Date of last update: 03 Aug 2025

Sources: Florida Department of State