| Entity Name: | FAMILY MEDICAL GROUP PEMBROKE PINES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Sep 2023 (a year ago) |
| Document Number: | L23000443430 |
| FEI/EIN Number | 93-3570957 |
| Address: | 9050 PINES BLVD. SUITE 335, PEMBROKE PINES, FL 33024 |
| Mail Address: | 9050 PINES BLVD. SUITE 335, PEMBROKE PINES, FL 33024 |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942051297 | 2024-03-27 | 2024-03-27 | 9050 PINES BLVD STE 335, PEMBROKE PINES, FL, 330246442, US | 9050 PINES BLVD STE 335, PEMBROKE PINES, FL, 330246442, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 954-256-5552 |
Authorized person
| Name | LIZSANDRA RODRIGUEZ |
| Role | OWNER |
| Phone | 7863997390 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| LJIR ENTERPRISES LLC | Agent |
| Name | Role |
|---|---|
| LJIR ENTERPRISES LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000137902 | FAMILY SPINE AND PAIN INSTITUTE PINES | ACTIVE | 2024-11-13 | 2029-12-31 | No data | 9050 PINES BLVD STE 335, PEMBROKE PINES, FL, 33024 |
| G24000132574 | FAMILY SPINE AND PAIN INSTITUTE | ACTIVE | 2024-10-29 | 2029-12-31 | No data | 9050 PINES BLVD. SUITE 335, PEMBROKE PINES, FL, 33024 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-22 | 9000 SW 137TH AVE, SUITE 201, MIAMI, FL 33186 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| Florida Limited Liability | 2023-09-25 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
