Search icon

PEMBROKE LAKES MALL DENTAL, P.A. - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: PEMBROKE LAKES MALL DENTAL, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 13 Sep 2022 (3 years ago)
Document Number: P22000071372
FEI/EIN Number 92-0345702
Address: 11401 PINES BLVD., PEMBROKE PINES, FL, 33026, US
Mail Address: C/O STOMATCARE DSO, LLC, 333 SE 2ND AVE SUITE 2540, MIAMI, FL, 33131, US
ZIP code: 33026
City: Hollywood
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
KRASNOV ROSTISLAV DDS Director 333 SE 2ND AVE., SUITE 2520, MIAMI, FL, 33131
KRASNOV ROSTISLAV DDS President 333 SE 2ND AVE., SUITE 2520, MIAMI, FL, 33131
KRASNOV ROSTISLAV DDS Treasurer 333 SE 2ND AVE., SUITE 2520, MIAMI, FL, 33131
KRASNOV ROSTISLAV DDS Secretary 333 SE 2ND AVE., SUITE 2520, MIAMI, FL, 33131
KRASNOV ROSTISLAV DDS Agent 333 SE 2ND AVE., MIAMI, FL, 33131

National Provider Identifier

NPI Number:
1144945882
Certification Date:
2022-10-12

Authorized Person:

Name:
ROSTISLAV KRASNOV
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Documents

Name Date
ANNUAL REPORT 2025-02-09
ANNUAL REPORT 2024-02-08
ANNUAL REPORT 2023-01-24
Domestic Profit 2022-09-13

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 01 Aug 2025

Sources: Florida Department of State