| Entity Name: | MEDBETTER HEALTH PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Jun 2021 (4 years ago) |
| Document Number: | P21000055439 |
| FEI/EIN Number | 87-1176392 |
| Address: | 3100 RAY FERRERO JR BLVD, FORT LAUDERDALE, FL, 33314, US |
| Mail Address: | 3100 RAY FERRERO JR BLVD, FORT LAUDERDALE, FL, 33314, US |
| ZIP code: | 33314 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447828561 | 2021-06-15 | 2023-07-24 | 3100 RAY FERRERO JR BLVD STE 5031A, DAVIE, FL, 333141013, US | 3100 RAY FERRERO JR BLVD, DAVIE, FL, 333141013, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-339-1756 |
| Fax | 6469749264 |
Authorized person
| Name | ERIK ILYAYEV |
| Role | OWNER |
| Phone | 7868025942 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ILYAYEV ERIK | Agent | 3100 RAY FERRERO JR BLVD, FORT LAUDERDALE, FL, 33314 |
| Name | Role | Address |
|---|---|---|
| ILYAYEV ERIK | President | 3905 SW 53RD CT, FORT LAUDERDALE, FL, 33312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-20 | 3100 RAY FERRERO JR BLVD, FORT LAUDERDALE, FL 33314 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-20 | 3100 RAY FERRERO JR BLVD, FORT LAUDERDALE, FL 33314 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-20 | 3100 RAY FERRERO JR BLVD, FORT LAUDERDALE, FL 33314 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-16 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-04-21 |
| Domestic Profit | 2021-06-11 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
