| Entity Name: | PATHOLOGY NETWORK LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 31 Aug 2023 (a year ago) |
| Document Number: | L23000409661 |
| FEI/EIN Number | 93-3266096 |
| Address: | 160 SW 12TH AVE, STE 103, DEERFIELD BEACH, FL 33442 |
| Mail Address: | 160 SW 12TH AVE, STE 103, DEERFIELD BEACH, FL 33442 |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457195109 | 2024-06-19 | 2024-06-25 | 160 SW 12TH AVE STE 103A, DEERFIELD BEACH, FL, 334423120, US | 160 SW 12TH AVE STE 103C, DEERFIELD BEACH, FL, 334423119, US | |||||||||||||||||||||
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| Phone | +1 561-507-0522 |
Authorized person
| Name | ANNA DZEVA |
| Role | AUTHORIZED OFFICIAL |
| Phone | 7864478424 |
Taxonomy
| Taxonomy Code | 207ZP0102X - Anatomic Pathology & Clinical Pathology Physician |
| Is Primary | No |
| Taxonomy Code | 207ZP0105X - Clinical Pathology/Laboratory Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GERSTEIN, ROBERT | Agent | 160 SW 12TH AVE, STE 103, DEERFIELD BEACH, FL 33442 |
| Name | Role | Address |
|---|---|---|
| DZEVA, ANNA | President | 160 SW 12TH AVE, STE 103, DEERFIELD BEACH, FL 33442 |
| Name | Role | Address |
|---|---|---|
| GERSTEIN, ROBERT | Manager | 160 SW 12TH AVE, STE 103, DEERFIELD BEACH, FL 33442 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| Florida Limited Liability | 2023-08-31 |
Date of last update: 09 Jan 2025
Sources: Florida Department of State
