| Entity Name: | PHYSICIANS PARTNERSHIP ALLIANCE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Sep 2023 (a year ago) |
| Document Number: | L23000423303 |
| FEI/EIN Number | 93-3356328 |
| Address: | 10081 PINES BLVD, B, PEMBROKE PINES, FL 33024 |
| Mail Address: | 10081 PINES BLVD, B, PEMBROKE PINES, FL 33024 |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023896016 | 2023-09-20 | 2023-09-20 | 10081 PINES BLVD STE B, PEMBROKE PINES, FL, 330246171, US | 10081 PINES BLVD STE B, PEMBROKE PINES, FL, 330246171, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 954-251-1175 |
| Fax | 7867320460 |
Authorized person
| Name | ALBERTO MANZOR |
| Role | DOCTOR |
| Phone | 3058783072 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | ALBERTO MANZOR |
| Number | 1134407307 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANZOR, ALBERTO | Agent | 10081 PINES BLVD, B, PEMBROKE PINES, FL 33024 |
| Name | Role | Address |
|---|---|---|
| MANZOR, ALBERTO | Authorized Member | 10081, PINES BLVD STE B PEMBROKE PINES, FL 33024 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| Florida Limited Liability | 2023-09-11 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
