| Entity Name: | EKOS LAKE NONA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Aug 2024 (6 months ago) |
| Document Number: | L24000358729 |
| Address: | 8794 W BOYNTON BEACH BLVD, SUITE 218, BOYNTON BEACH, FL 33472 |
| Mail Address: | 8794 W BOYNTON BEACH BLVD, SUITE 218, BOYNTON BEACH, FL 33472 |
| ZIP code: | 33472 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851125264 | 2024-08-28 | 2024-08-28 | 8794 BOYNTON BEACH BLVD STE 218, BOYNTON BEACH, FL, 334724469, US | 9436 NARCOOSSEE RD, ORLANDO, FL, 328275705, US | |||||||||||||
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| Phone | +1 321-300-2235 |
Authorized person
| Name | GIO DEJESUS |
| Role | OPERATIONS |
| Phone | 8133400116 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TOMALTY, SEAN A | Agent | 8794 W BOYNTON BEACH BLVD, SUITE 218, BOYNTON BEACH, FL 33472 |
| Name | Role | Address |
|---|---|---|
| TOMALTY, SEAN A, DMD | Manager | 8794 W BOYNTON BEACH BLVD SUITE 218, BOYNTON BEACH, FL 33472 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-08-15 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
