| Entity Name: | ABBIEJEAN RUSSELL CARE CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
ABBIEJEAN RUSSELL CARE CENTER, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Mar 2003 (22 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | L03000009831 |
| FEI/EIN Number |
NOT APPLICABLE
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL, 33179, US |
| Mail Address: | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL, 33179, US |
| ZIP code: | 33179 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770595738 | 2006-08-11 | 2012-07-31 | 700 S 29TH ST, FORT PIERCE, FL, 349473626, US | 700 S 29TH ST, FORT PIERCE, FL, 349473626, US | |||||||||||||||||||||||||||||||
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| Phone | +1 772-465-7560 |
| Fax | 7724655619 |
Authorized person
| Name | MARIA ELVA GONZALEZ |
| Role | OWNER |
| Phone | 7863854364 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF10020961 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 026875500 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | M4K |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Fannin Deborah | Manager | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL, 33179 |
| Gonzalez Maria E | Manager | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL, 33179 |
| JEROSLOW LOUISE T | Agent | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL, 33179 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-30 | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL 33179 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-20 | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL 33179 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-20 | 1835 ne Miami Gardens Dr 167, North Miami Beach, FL 33179 | - |
| LC STMNT OF AUTHORITY | 2014-08-22 | - | - |
| REGISTERED AGENT NAME CHANGED | 2006-03-22 | JEROSLOW, LOUISE T | - |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2022-10-18 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-04-09 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-04-06 |
| CORLCAUTH | 2014-08-22 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 315360198 | 0418800 | 2012-01-27 | 700 S 29TH ST, FT PIERCE, FL, 34947 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19100212 A01 |
| Issuance Date | 2012-02-10 |
| Abatement Due Date | 2012-02-24 |
| Current Penalty | 1530.0 |
| Initial Penalty | 3060.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 05 |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19100212 B |
| Issuance Date | 2012-02-10 |
| Abatement Due Date | 2012-01-27 |
| Current Penalty | 975.0 |
| Initial Penalty | 1950.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 01 |
| Citation ID | 01003 |
| Citaton Type | Serious |
| Standard Cited | 19100215 B09 |
| Issuance Date | 2012-02-10 |
| Abatement Due Date | 2012-02-15 |
| Current Penalty | 1530.0 |
| Initial Penalty | 3060.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 05 |
| Citation ID | 02001 |
| Citaton Type | Other |
| Standard Cited | 19100133 A01 |
| Issuance Date | 2012-02-10 |
| Abatement Due Date | 2012-02-16 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 01 |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19101200 H01 |
| Issuance Date | 2012-02-10 |
| Abatement Due Date | 2012-02-16 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5642587107 | 2020-04-13 | 0455 | PPP | 700 S 29TH ST, FORT PIERCE, FL, 34947-3626 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
