| Entity Name: | TIMOTHY S. SALIB, DMD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Jul 2021 (4 years ago) |
| Document Number: | P21000064169 |
| FEI/EIN Number | 87-1900825 |
| Address: | 718 SE BECKER ROAD, PORT ST. LUCIE, FL, 34984, US |
| Mail Address: | 718 SE Becker Road, PORT ST. LUCIE, FL, 34984, US |
| ZIP code: | 34984 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700543378 | 2021-11-18 | 2021-11-18 | 718 SE BECKER RD, PORT ST. LUCIE, FL, 34984, US | 718 SE BECKER RD, PORT ST. LUCIE, FL, 34984, US | |||||||||||||
|
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| Phone | +1 772-336-2300 |
Authorized person
| Name | DR. TIMOTHY S SALIB |
| Role | PRESIDENT |
| Phone | 3217591462 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SALIB TIMOTHY S | Agent | 718 SE BECKER ROAD, PORT ST. LUCIE, FL, 34984 |
| Name | Role | Address |
|---|---|---|
| SALIB TIMOTHY S | President | 718 SE BECKER ROAD, PORT ST. LUCIE, FL, 34984 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000018487 | VERANDA FAMILY DENTISTRY | ACTIVE | 2022-01-30 | 2027-12-31 | No data | 718 SE BECKER ROAD, PORT ST LUCIE, FL, 34984 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-31 | 718 SE BECKER ROAD, PORT ST. LUCIE, FL 34984 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-02-01 |
| Domestic Profit | 2021-07-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
