| Entity Name: | MD ON THE GO PCP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 Jun 2024 (8 months ago) |
| Document Number: | L24000270527 |
| Address: | 3458 LAKESHORE DRIVE, TALLAHASSEE, FL 32312 |
| Mail Address: | 3458 LAKESHORE DRIVE, TALLAHASSEE, FL 32312 |
| ZIP code: | 32312 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770329450 | 2024-07-02 | 2024-07-18 | 1401 N UNIVERSITY DR STE 305, CORAL SPRINGS, FL, 330716088, US | 1401 N UNIVERSITY DR STE 305, CORAL SPRINGS, FL, 330716088, US | |||||||||||||
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| Phone | +1 561-849-4810 |
Authorized person
| Name | DR. MARIA PEREA BARBOSA |
| Role | MEDICAL DIRECTOR |
| Phone | 2018952091 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| INCORP SERVICES, INC. | Agent |
| Name | Role |
|---|---|
| SIGA, LLC | Authorized Member |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-06-13 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
