| Entity Name: | MIAMI BEHAVIORAL HEALTH CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Nov 1977 (47 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 29 Mar 2010 (15 years ago) |
| Document Number: | 741133 |
| FEI/EIN Number | 59-1787777 |
| Address: | 2300 NW 89th Place, Doral, FL 33172 |
| Mail Address: | 2300 NW 89th Place, Doral, FL 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1457319451 | 2006-05-02 | 2015-10-07 | 6100 BLUE LAGOON DR, SUITE400, MIAMI, FL, 331262079, US | 3850 W FLAGLER ST, CORAL GABLES, FL, 331341604, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-398-6100 |
| Fax | 3057572387 |
| Phone | +1 305-774-3300 |
Authorized person
| Name | ILEANA RUIZ GARCIA |
| Role | COO |
| Phone | 3053986100 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 1113AD777700 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 104100000X - Social Worker |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
| Taxonomy Code | 163W00000X - Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 164W00000X - Licensed Practical Nurse |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | 1113AD777700 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002340400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305824 |
| State | FL |
| Issuer | MEDICAID |
| Number | 109574900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305815 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305810 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305828 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305818 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305819 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305803 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305804 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305805 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305806 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305811 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305812 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305822 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305808 |
| State | FL |
| Issuer | MEDICAID |
| Number | 060305816 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Fernandez, Manuel A. | Agent | 2300 NW 89th Place, Doral, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Rutledge , Pierre | Chairman | 2300 NW 89th Place, Doral, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Palmar, Joseph | Secretary | 2300 NW 89th Place, Doral, FL 33172 |
| Name | Role | Address |
|---|---|---|
| O'Naghten, Cristina | Treasurer | 2300 NW 89th Place, Doral, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Fernandez, Manuel A. | Chief Operating Officer | 2300 NW 89th Place, Doral, FL 33172 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000092479 | BANYAN HEALTH SYSTEMS, INC. | EXPIRED | 2012-09-20 | 2017-12-31 | No data | 11031 NE 6TH AVENUE, MIAMI, FL, 33161 |
| G12000088762 | THE BANYAN ART CHALLENGE | EXPIRED | 2012-09-10 | 2017-12-31 | No data | 11031 NE 6TH AVENUE, MIAMI, FL, 33161 |
| G08343900007 | POR TU SALUD MEDICAL CENTER | EXPIRED | 2008-12-08 | 2013-12-31 | No data | 11031 NE 6 AVENUE, MIAMI, FL, 33161 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-06-19 | Fernandez, Manuel A. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-08 | 2300 NW 89th Place, Doral, FL 33172 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-08 | 2300 NW 89th Place, Doral, FL 33172 | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-08 | 2300 NW 89th Place, Doral, FL 33172 | No data |
| AMENDMENT | 2010-03-29 | No data | No data |
| REINSTATEMENT | 2000-11-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2000-09-22 | No data | No data |
| NAME CHANGE AMENDMENT | 1996-12-10 | MIAMI BEHAVIORAL HEALTH CENTER, INC. | No data |
| NAME CHANGE AMENDMENT | 1984-07-17 | MIAMI MENTAL HEALTH CENTER, INC. | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-06-19 |
| ANNUAL REPORT | 2024-05-08 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-05-18 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-09-15 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-03-01 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
