| Entity Name: | LA VIDA MEDICAL GROUP INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Jun 2021 (4 years ago) |
| Document Number: | P21000055694 |
| FEI/EIN Number | 87-1264255 |
| Address: | 120 STATE ST E, OLDSMAR, FL, 34677, US |
| Mail Address: | 120 STATE ST E, OLDSMAR, FL, 34677, US |
| ZIP code: | 34677 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982377065 | 2021-07-26 | 2023-03-10 | 120 STATE ST E STE 101, OLDSMAR, FL, 346773647, US | 120 STATE ST E STE 101, OLDSMAR, FL, 346773647, US | |||||||||||||||
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| Phone | +1 813-296-6266 |
| Fax | 8135228929 |
Authorized person
| Name | SANLLY PEREZ CEBALLOS |
| Role | PRESIDENT |
| Phone | 8132966266 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEREZ CEBALLOS SANLLY | Agent | 120 STATE ST E, OLDSMAR, FL, 34677 |
| Name | Role | Address |
|---|---|---|
| PEREZ CEBALLOS SANLLY | President | 120 STATE ST E, OLDSMAR, FL, 34677 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-04 | 120 STATE ST E, SUITE 101, OLDSMAR, FL 34677 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-09-08 | 120 STATE ST E, SUITE 101, OLDSMAR, FL 34677 | No data |
| CHANGE OF MAILING ADDRESS | 2021-09-08 | 120 STATE ST E, SUITE 101, OLDSMAR, FL 34677 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-03-02 |
| Domestic Profit | 2021-06-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
