| Name: | St. Jude Thaddeus, Internal Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 22 Oct 2010 (14 years ago) |
| Date of dissolution: | 30 Sep 2013 |
| Entity Number: | 000-303-495 |
| Register Number: | 000303495 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 840 MONTCLAIR RD STE 606BIRMINGHAM, AL 35213 |
| Registered Office Street Address ZIP Code: | 35213 |
Activities
INTERNAL MEDICINE CLINIC/PAIN CLINIC/MEDICAL REVIEW OFFICER SVCS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427325687 | 2011-11-16 | 2011-11-16 | 5431 BEACON DR, IRONDALE, AL, 352102862, US | 5431 BEACON DR, IRONDALE, AL, 352102862, US | |||||||||||||||||||
|
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| Phone | +1 205-956-8767 |
| Fax | 2059568704 |
Authorized person
| Name | DR. RODOLFO M VELUZ |
| Role | MEDICAL DIRECTOR |
| Phone | 2059568767 |
Taxonomy
| Taxonomy Code | 146M00000X - Intermediate Emergency Medical Technician |
| License Number | MD 9246 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VELUZ, MILA M | Agent | 5415 BEACON DRIVEBIRMINGHAM, AL 35210 |
| Name | Role |
|---|---|
| VELUZ, RUDY | Member |
| VELUZ, MILA | Member |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
