Search icon

MARLEY MEDICAL PROVIDER GROUP, P.A. - Florida Company Profile

Headquarter
Company claim

Is this your business?

Get access!

Company Details

Entity Name: MARLEY MEDICAL PROVIDER GROUP, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 12 Jan 2022 (4 years ago)
Document Number: P22000002702
FEI/EIN Number 87-4414073
Address: 2332 Galiano Street 2nd Floor, Coral Gables, FL, 33134, US
Mail Address: 2332 Galiano Street 2nd Floor, Coral Gables, FL, 33134, US
ZIP code: 33134
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Links between entities

Type:
Headquarter of
Company Number:
10303929
State:
ALASKA
Type:
Headquarter of
Company Number:
CORP_73828325
State:
ILLINOIS
Type:
Headquarter of
Company Number:
undefined605656677
State:
WASHINGTON
Type:
Headquarter of
Company Number:
84851081-54ef-ec11-91bc-00155d32b93a
State:
MINNESOTA

Key Officers & Management

Name Role Address
- Agent -
BAKHRU VIKRAM Manager 8605 SANTA MONICA BLVD, WEST HOLLYWOOD, FL, 90069

National Provider Identifier

NPI Number:
1487301917
Certification Date:
2025-05-30

Authorized Person:

Name:
DR. VIKRAM DEEPAK BAKHRU
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
No
Selected Taxonomy:
207QA0505X - Adult Medicine Physician
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G25000058121 STARLIGHT PROVIDER GROUP, P.C. ACTIVE 2025-04-30 2030-12-31 - 2332 GALIANO ST., 2ND FLOOR, CORAL GABLES, FL, 33134

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-12-09 2332 Galiano Street 2nd Floor, Coral Gables, FL 33134 -
CHANGE OF MAILING ADDRESS 2024-12-09 2332 Galiano Street 2nd Floor, Coral Gables, FL 33134 -

Documents

Name Date
ANNUAL REPORT 2024-03-01
ANNUAL REPORT 2023-03-09
Domestic Profit 2022-01-12

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 01 Jul 2025

Sources: Florida Department of State