| Entity Name: | TEBACARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Nov 2023 (a year ago) |
| Document Number: | L23000499136 |
| FEI/EIN Number | 93-4253976 |
| Address: | 261 N UNIVERSITY DR, SUITE 500 PMB 1064, PLANTATION, FL, 33324, US |
| Mail Address: | 261 N UNIVERSITY DR, SUITE 500 PMB 1064, PLANTATION, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730950510 | 2024-01-11 | 2024-02-23 | 261 N UNIVERSITY DR, SUITE 500 PMB 1064, PLANTATION, FL, 333242009, US | 261 N UNIVERSITY DR, SUITE 500 PMB 1064, PLANTATION, FL, 333242009, US | |||||||||||||
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| Phone | +1 786-396-0389 |
Authorized person
| Name | DR. PAVEL KUROSH |
| Role | PRIMARY CARE PROVIDER |
| Phone | 2392249547 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KUROSH PAVEL | Agent | 8809 W SUNRISE BLVD, PLANTATION, FL, 33322 |
| Name | Role | Address |
|---|---|---|
| KUROSH PAVEL | Manager | 8809 W SUNRISE BLVD, PLANTATION, FL, 33322 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-01 |
| Florida Limited Liability | 2023-11-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
