| Entity Name: | VITALMD GROUP HOLDING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
VITALMD GROUP HOLDING, 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 19 Sep 2003 (22 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 22 Apr 2024 (a year ago) |
| Document Number: | L03000036510 |
| FEI/EIN Number |
542129332
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3225 AVIATION AVENUE, SUITE 700, COCONUT GROVE, FL, 33133, US |
| Mail Address: | P.O. BOX 43-2040, MIAMI, FL, 33243-2040 |
| ZIP code: | 33133 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043984941 | 2021-08-04 | 2021-08-04 | 3225 AVIATION AVE FL 4, MIAMI, FL, 331334741, US | 3225 AVIATION AVE FL 4, MIAMI, FL, 331334741, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-273-4641 |
| Fax | 3056317680 |
Authorized person
| Name | MS. JESSICA CAPOTE |
| Role | MANAGED CARE DIRECTOR |
| Phone | 3052734641 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 103TF0000X - Family Psychologist |
| Is Primary | No |
| Taxonomy Code | 104100000X - Social Worker |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 269024100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VIZOSO JAVIER M | President | 7300 SW 62ND PLACE, 3RD FLOOR, SOUTH MIAMI, FL, 33143 |
| SALKIND GLENN | Exec | 8950 SW 74th Court, MIAMI, FL, 33156 |
| KUHN KERRY M | Vice President | 1725 N. UNIVERSITY DR., STE. 440, CORAL SPRINGS, FL, 33071 |
| Grenitz Mark M | Vice President | 220 SW 84th Ave, Plantation, FL, 33324 |
| ESSERMAN JAMES D | Vice President | 8950 SW 74th Court, MIAMI, FL, 33156 |
| FIDALGO EDWARD MMD | Secretary | 3659 S MIAMI AVE, STE. 5005, MIAMI, FL, 33133 |
| YELEN MITCHELL A | Agent | 3444 Main HWY., Miami, FL, 33133 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000050040 | BROWARD COMPLETE OB/GYN WELLNESS CENTER | ACTIVE | 2020-05-06 | 2025-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| G20000049660 | BERGMAN PEDIATRICS | ACTIVE | 2020-05-05 | 2025-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| G20000009425 | GUILLERMO RUIZ, MD, LLC | ACTIVE | 2020-01-21 | 2025-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| G20000006177 | BROWARD COMPLETE OB/GYN WELLNESS CENTER, LLC | ACTIVE | 2020-01-14 | 2025-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| G20000001448 | GEMINI OBSTETRICS/GYNECOLOGY, LLC | ACTIVE | 2020-01-04 | 2025-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| G19000073224 | BREAST CARE CENTER MIAMI | EXPIRED | 2019-07-02 | 2024-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33134 |
| G19000063922 | SAWGRASS WOMEN'S CENTER | EXPIRED | 2019-06-03 | 2024-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33131 |
| G19000061624 | BERGMAN PEDIATRICS | EXPIRED | 2019-05-24 | 2024-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33131 |
| G18000071554 | GREEN OB/GYN, ASSOCIATES | EXPIRED | 2018-06-26 | 2023-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| G18000057696 | WOMENS CARE OF BRADENTON | EXPIRED | 2018-05-10 | 2023-12-31 | - | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL, 33133 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-04-22 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-02 | 3444 Main HWY., 2nd Floor, Miami, FL 33133 | - |
| LC AMENDMENT | 2014-03-12 | - | - |
| LC AMENDMENT | 2012-03-16 | - | - |
| LC AMENDMENT | 2010-03-17 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2009-08-25 | 3225 AVIATION AVENUE, SUITE 700, COCONUT GROVE, FL 33133 | - |
| REGISTERED AGENT NAME CHANGED | 2005-05-09 | YELEN, MITCHELL A | - |
| CHANGE OF MAILING ADDRESS | 2004-12-22 | 3225 AVIATION AVENUE, SUITE 700, COCONUT GROVE, FL 33133 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J16000739916 | TERMINATED | 1000000726978 | BROWARD | 2016-11-14 | 2036-11-16 | $ 14,978.32 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J13000958141 | TERMINATED | 1000000503218 | LAKE | 2013-05-10 | 2033-05-22 | $ 4,861.69 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LEESBURG SERVICE CENTER, 1904 THOMAS AVE STE 103, LEESBURG FL347483289 |
| Name | Date |
|---|---|
| LC Amendment | 2024-04-22 |
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-16 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-05-13 |
| ANNUAL REPORT | 2020-04-01 |
| ANNUAL REPORT | 2019-02-12 |
| AMENDED ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2018-03-14 |
| ANNUAL REPORT | 2017-04-25 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
