| Entity Name: | PRIMARY CARE ASSOCIATES OF SOUTH BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 May 2005 (20 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L05000043240 |
| FEI/EIN Number | 300375389 |
| Address: | 14910 NE 8 Ave, MIAMI, FL, 33161, US |
| Mail Address: | 14910 NE 8 Ave, MIAMI, FL, 33161, US |
| ZIP code: | 33161 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487819942 | 2008-07-24 | 2008-07-24 | 1450 MERIDIAN AVE, SUITE 10, MIAMI BEACH, FL, 331398059, US | 2801 FLORIDA AVE, SUITE 10, MIAMI, FL, 331331905, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 305-534-8300 |
| Fax | 3055346445 |
Authorized person
| Name | DR. EDWARD MICHAEL FREEMAN |
| Role | PRESIDENT |
| Phone | 3055348300 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| License Number | 2987482 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | 2987482 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1194919050 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FREEMAN EDWARD M | Agent | 14910 NE 8 Ave, MIAMI, FL, 33161 |
| Name | Role | Address |
|---|---|---|
| FREEMAN EDWARD M | Managing Member | 14910 NE 8 Ave, MIAMI, FL, 33161 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-05-30 | 14910 NE 8 Ave, MIAMI, FL 33161 | No data |
| CHANGE OF MAILING ADDRESS | 2013-05-30 | 14910 NE 8 Ave, MIAMI, FL 33161 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-05-30 | 14910 NE 8 Ave, MIAMI, FL 33161 | No data |
| REINSTATEMENT | 2010-09-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-05-30 |
| ANNUAL REPORT | 2012-02-03 |
| ANNUAL REPORT | 2011-01-24 |
| REINSTATEMENT | 2010-09-29 |
| ANNUAL REPORT | 2009-03-08 |
| ANNUAL REPORT | 2008-01-03 |
| ANNUAL REPORT | 2007-03-20 |
| ANNUAL REPORT | 2006-01-07 |
| Florida Limited Liability | 2005-05-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
