| Entity Name: | ARA-SEBRING DIALYSIS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Jun 2002 (23 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2022 (3 years ago) |
| Document Number: | L02000013610 |
| FEI/EIN Number | 13-4264684 |
| Address: | 500 Cummings Center, Beverly, MA, 01915, US |
| Mail Address: | 4245 Sun n' Lake Blvd, Sebring, FL, 33872, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023041456 | 2006-07-09 | 2023-01-10 | 4245 SUN N LAKE BLVD, SEBRING, FL, 338722158, US | 4245 SUN N LAKE BLVD, SEBRING, FL, 338722158, US | |||||||||||||||||||||
|
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| Phone | +1 863-382-9443 |
| Fax | 8633829242 |
Authorized person
| Name | SARA ANNE BRADY |
| Role | CHIEF NURSING |
| Phone | 2083717878 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 892649200 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| AMERICAN RENAL ASSOCIATES LLC | Member | No data |
| The Ernesto Pinzon Irrevocable Trust | Member | 500 Cummings Center, Beverly, MA, 01915 |
| Name | Role | Address |
|---|---|---|
| Attmore George | Manager | 500 Cummings Center, Beverly, MA, 01915 |
| Kamal Syed T | Manager | 500 Cummings Center, Beverly, MA, 01915 |
| Abanilla Fernando M. M.D. | Manager | 500 Cummings Center, Beverly, MA, 01915 |
| Pinzon Ernesto M.D. | Manager | 500 Cummings Center, Beverly, MA, 01915 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000120397 | HIGHLANDS DIALYSIS CENTER | ACTIVE | 2011-12-12 | 2026-12-31 | No data | 4245 SUN N. LAKE BLVD, SEBRING, FL, 33872 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-22 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-22 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | No data |
| LC STMNT OF RA/RO CHG | 2022-05-17 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-05-17 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-17 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-28 |
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-02-22 |
| CORLCRACHG | 2022-05-17 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-17 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-04-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
