| Entity Name: | SOUTHERN INTERNAL MEDICINE ASSOCIATES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Oct 2024 (4 months ago) |
| Document Number: | L24000438483 |
| Address: | 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308 |
| Mail Address: | 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308 |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639909658 | 2024-08-05 | 2024-08-05 | 1300 MEDICAL DR, TALLAHASSEE, FL, 323084646, US | 1300 MEDICAL DR, TALLAHASSEE, FL, 323084646, US | |||||||||||||
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| Phone | +1 850-216-0100 |
Authorized person
| Name | IMMANUEL ARUN DHANARAJAN |
| Role | CFO |
| Phone | 8507272459 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WALGAMOTT, BRIAN | Agent | 2615 CENTENNIAL BLVD, STE 200, TALLAHASSEE, FL 32308--059 |
| Name | Role | Address |
|---|---|---|
| MITAL, SATISH | Manager | 1300 MEDICAL DRIVE, TALLAHASSEE, F 32320-8 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-10-14 |
Date of last update: 06 Jan 2025
Sources: Florida Department of State
