| Entity Name: | PRIME PEDIATRIC DENTAL GROUP, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 04 May 2023 (2 years ago) |
| Document Number: | P23000035625 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 13195 BISCAYNE BAY DRIVE, NORTH MIAMI, FL |
| Mail Address: | 13195 BISCAYNE BAY DRIVE, NORTH MIAMI, FL |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528885910 | 2024-09-25 | 2024-09-30 | 2950 SW 8TH ST, MIAMI, FL, 331352827, US | 2950 SW 8TH ST, MIAMI, FL, 331352827, US | |||||||||||||
|
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| Phone | +1 305-251-5390 |
Authorized person
| Name | DR. JOSE MELLADO |
| Role | PRESIDENT |
| Phone | 3052515390 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MARX ROSENTHAL PLLC | Agent |
| Name | Role | Address |
|---|---|---|
| Mellado, Jose | Director | 13195 BISCAYNE BAY DRIVE, NORTH MIAMI, FL |
| Cabrerizo, Ania | Director | 13195 BISCAYNE BAY DRIVE, NORTH MIAMI, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-01 | 13195 BISCAYNE BAY DRIVE, NORTH MIAMI, FL | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 13195 BISCAYNE BAY DRIVE, NORTH MIAMI, FL | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| Domestic Profit | 2023-05-04 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
