| Entity Name: | PHYSICIAN PARTNERS GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Oct 2024 (4 months ago) |
| Document Number: | L24000430849 |
| Address: | 2664 SW 87TH AVE, MIAMI, FL 33165 |
| Mail Address: | 2664 SW 87TH AVE, MIAMI, FL 33165 |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851113120 | 2024-10-29 | 2024-10-29 | 2664 SW 87TH AVE, MIAMI, FL, 331652031, US | 2664 SW 87TH AVE, MIAMI, FL, 331652031, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 877-866-7123 |
Authorized person
| Name | AIMEE GONZALEZ |
| Role | OWNER |
| Phone | 8778667123 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, AIMEE | Agent | 2664 SW 87TH AVE, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, AIMEE | Manager | 2664 SW 87TH AVE, MIAMI, FL 33165 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-10-07 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
