| Entity Name: | AETNA SPECIALTY PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 24 Aug 2004 (20 years ago) |
| Date of dissolution: | 10 Nov 2023 (a year ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 10 Nov 2023 (a year ago) |
| Document Number: | M04000003460 |
| FEI/EIN Number | 57-1209768 |
| Address: | 503 Sunport Lane, Orlando, FL 32809 |
| ZIP code: | 32809 |
| County: | Orange |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386060580 | 2014-03-12 | 2014-03-12 | 503 SUNPORT LN, ORLANDO, FL, 328097874, US | 503 SUNPORT LN, ORLANDO, FL, 328097874, US | |||||||||||||
|
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| Phone | +1 407-513-1880 |
Authorized person
| Name | NEREIDA PADILLA |
| Role | PHARMACIST IN CHARGE |
| Phone | 4075138626 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Lee, Edward Chung-I | Secretary | 151 Farmington Avenue, RW61, Hartford, CT 06156 |
| Name | Role | Address |
|---|---|---|
| Aetna Health Holdings, LLC | Member | 503 Sunport Lane, Orlando, FL 32809 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2023-11-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-12 | 503 Sunport Lane, Orlando, FL 32809 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-05 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-04-05 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| WITHDRAWAL | 2023-11-10 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-05-04 |
| ANNUAL REPORT | 2019-03-22 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-04-03 |
| ANNUAL REPORT | 2016-04-01 |
| ANNUAL REPORT | 2015-04-09 |
Date of last update: 05 Jan 2025
Sources: Florida Department of State
