| Entity Name: | WJ BONNER MD PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 May 2023 (2 years ago) |
| Document Number: | L23000252314 |
| FEI/EIN Number | 93-1518786 |
| Address: | 4960 SW 72nd Ave, SUITE 408, MIAMI, FL, 33155, US |
| Mail Address: | 12051 SW 69TH PL, PINECREST, FL, 33156 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144913732 | 2023-05-30 | 2023-12-03 | 12051 SW 69TH PL, PINECREST, FL, 331565429, US | 4960 SW 72ND AVE STE 408, MIAMI, FL, 331555506, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 610-529-4407 |
| Phone | +1 786-522-4959 |
| Fax | 7865224959 |
Authorized person
| Name | DR. WILLIAM JAMES BONNER |
| Role | MANAGER |
| Phone | 6105294407 |
Taxonomy
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BONNER WILLIAM J | Agent | 12051 SW 69TH PL, PINECREST, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| BONNER WILLIAM J | Manager | 12051 SW 69TH PL, PINECREST, FL, 33156 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 4960 SW 72nd Ave, SUITE 408, MIAMI, FL 33155 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| Florida Limited Liability | 2023-05-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
