Detail by Entity Name

Florida Limited Liability Company

RAFAEL PELEGRIN MD MEDICAL GROUP, LLC

Filing Information
L04000001929 20-0561504 01/08/2004 01/07/2004 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/26/2008 NONE
Principal Address
7863 SW 195 TERRACE
MIAMI, FL 33157

Changed: 05/02/2007
Mailing Address
7863 SW 195 TERRACE
MIAMI, FL 33157

Changed: 05/02/2007
Registered Agent Name & Address PB&A FINANCIAL SERVICES, CORP
174 N.E. 96TH STREET
MIAMI SHORES, FL 33138

Name Changed: 05/02/2007

Address Changed: 02/07/2006
Authorized Person(s) Detail Name & Address

Title MGR

RAFAEL PELEGRIN, MD, PA
10661 N. KENDALL DRIVE, SUITE 113
MIAMI, FL 33176

Title MGRM

BAUTISTA, FRANCISCO MD
10661 S. W. 88TH STREET, SUITE 113
MIAMI, FL 33176

Title MGRM

DIAZ, JOSE A
4200 SW 152ND AVE
MIRAMAR, FL 33027

Annual Reports
Report YearFiled Date
2005 04/29/2005
2006 02/07/2006
2007 05/02/2007