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WHITE SANDS MEDICAL GROUP, LLC - Florida Company Profile

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Company Details

Entity Name: WHITE SANDS MEDICAL GROUP, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 24 Oct 2023 (2 years ago)
Document Number: M23000013624
FEI/EIN Number 933674482

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1702 OHIO AVE, LYNN HAVEN, FL, 32444, US
Mail Address: 1702 OHIO AVE, LYNN HAVEN, FL, 32444, US
ZIP code: 32444
County: Bay
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
MOZAFFARI FARID Manager 1702 OHIO AVE, LYNN HAVEN, FL, 32444
HOWELL CPA GROUP Agent 408 W BALDWIN RD, PANAMA CITY, FL, 32405

National Provider Identifier

NPI Number:
1801676531
Certification Date:
2025-01-31

Authorized Person:

Name:
DR. FARID BRAD MOZAFFARI
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2086S0122X - Plastic and Reconstructive Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
8502488825

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000131518 PLASTIC SURGERY INSTITUTE & SPA ACTIVE 2023-10-25 2028-12-31 - 1702 OHIO AVE, LYNN HAVEN, FL, 32444

Documents

Name Date
ANNUAL REPORT 2024-04-23
Foreign Limited 2023-10-24

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Date of last update: 02 Jun 2025

Sources: Florida Department of State