| Entity Name: | BLUE PARK DENTAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Nov 2023 (a year ago) |
| Document Number: | L23000520495 |
| FEI/EIN Number | 93-4536572 |
| Address: | 5470 Post Oak Blvd Unit 1, WESLEY CHAPEL, FL, 33544, US |
| Mail Address: | 5470 Post Oak Blvd unit 1, WESLEY CHAPEL, FL, 33544, US |
| ZIP code: | 33544 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174391460 | 2023-12-15 | 2023-12-15 | 3182 FRESNO PL, ZEPHYRHILLS, FL, 335412935, US | 5470 POST OAK BLVD UNIT 1, WESLEY CHAPEL, FL, 33544, US | |||||||||||||
|
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| Phone | +1 407-455-3486 |
Authorized person
| Name | JORDAN BROWN |
| Role | DENTIST |
| Phone | 4074553486 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BROWN JORDAN A | Agent | 5470 Post Oak Blvd Unit 1, WESLEY CHAPEL, FL, 33544 |
| Name | Role | Address |
|---|---|---|
| BROWN JORDAN A | Manager | 5470 Post Oak Blvd Unit 1, WESLEY CHAPEL, FL, 33544 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-05 | 5470 Post Oak Blvd Unit 1, WESLEY CHAPEL, FL 33544 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-05 | 5470 Post Oak Blvd Unit 1, WESLEY CHAPEL, FL 33544 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-05 | 5470 Post Oak Blvd Unit 1, WESLEY CHAPEL, FL 33544 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| Florida Limited Liability | 2023-11-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
