| Entity Name: | MY DENTIST OF FORT LAUDERDALE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Mar 2024 (a year ago) |
| Document Number: | L24000142573 |
| Address: | 2500 E Oakland Park Blvd, FORT LAUDERDALE, FL 33308 |
| Mail Address: | 4500 BAYVIEW DRIVE, FORT LAUDERDALE, FL 33308 |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154168193 | 2024-07-09 | 2024-07-09 | 2500 E OAKLAND PARK BLVD, FORT LAUDERDALE, FL, 333061601, US | 2500 E OAKLAND PARK BLVD, FORT LAUDERDALE, FL, 333061601, US | |||||||||||||
|
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| Phone | +1 954-408-9282 |
Authorized person
| Name | DR. ZELJKA LICINA |
| Role | OWNER DENTIST |
| Phone | 9544089282 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LICINA, ZELJKA | Agent | 4500 BAYVIEW DR, FORT LAUDERDALE, FL 33308 |
| Name | Role | Address |
|---|---|---|
| LICINA, ZELJKA | Authorized Member | 4500 BAYVIEW DR, FORT LAUDERDALE, FL 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-09 | 2500 E Oakland Park Blvd, FORT LAUDERDALE, FL 33308 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-03-22 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
