| Entity Name: | PRESTIGE CARDIOLOGY ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Aug 2024 (6 months ago) |
| Document Number: | L24000338959 |
| Address: | 3800 WEST BROWARD BLVD SUITE, 101 RM 8, PLANTATION, FL 33312 |
| Mail Address: | 3800 WEST BROWARD BLVD SUITE, 101 RM 8, PLANTATION, FL 33312 |
| ZIP code: | 33312 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609607175 | 2024-08-08 | 2024-08-08 | 3800 W BROWARD BLVD STE 101 RM 5C, FORT LAUDERDALE, FL, 333121018, US | 3800 W BROWARD BLVD STE 101 RM 5C, FORT LAUDERDALE, FL, 333121018, US | |||||||||||||
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| Phone | +1 469-485-3166 |
Authorized person
| Name | AL BERRY |
| Role | CREDENTIALING COORDINATOR |
| Phone | 4694853166 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HENRY, ODAZIE | Agent | 301 SW 1ST AVE, 2019, FORT LAUDERDALE, FL 33301 |
| Name | Role | Address |
|---|---|---|
| ODAZIE, HENRY | Authorized Person | 301, SW 1ST FIRST AVENUE ,UNIT 2019 FORT LAUDERDALE, FL 33301 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-08-01 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
