| Entity Name: | BETHESTA HOME HEALTH CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 May 2005 (20 years ago) |
| Date of dissolution: | 18 Apr 2013 (12 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 18 Apr 2013 (12 years ago) |
| Document Number: | L05000049698 |
| FEI/EIN Number | 203353247 |
| Address: | 2500 NW 79TH AVE STE 271, MIAMI, FL, 33122, US |
| Mail Address: | 2500 NW 79TH AVE STE 271, MIAMI, FL, 33122, US |
| ZIP code: | 33122 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952323123 | 2006-07-24 | 2012-12-11 | 2500 NW 79TH AVE STE 271, DORAL, FL, 331221089, US | 2500 NW 79TH AVE STE 120, DORAL, FL, 331221031, US | |||||||||||||||||||||||||||
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| Phone | +1 305-629-6426 |
| Fax | 3056296426 |
| Phone | +1 305-629-6425 |
Authorized person
| Name | MANUEL LEON |
| Role | MANAGER |
| Phone | 7863445492 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299992294 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 651305100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEON MANUEL | Agent | 2500 NW 79TH AVE STE 271, MIAMI, FL, 33122 |
| Name | Role | Address |
|---|---|---|
| LEON MANUEL | PRSD | 2500 NW 79TH AVE SUITE 120, DORAL, FL, 33122 |
| Name | Role | Address |
|---|---|---|
| ITURRIAGA IGOR | Managing Member | 2500 NW 79TH AVE STE 271, MIAMI, FL, 33122 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-18 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-12-06 | 2500 NW 79TH AVE STE 271, MIAMI, FL 33122 | No data |
| LC AMENDMENT | 2012-12-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-12-06 | 2500 NW 79TH AVE STE 271, MIAMI, FL 33122 | No data |
| CHANGE OF MAILING ADDRESS | 2012-12-06 | 2500 NW 79TH AVE STE 271, MIAMI, FL 33122 | No data |
| LC AMENDMENT | 2011-07-21 | No data | No data |
| CANCEL ADM DISS/REV | 2009-09-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-18 |
| LC Amendment | 2012-12-06 |
| ANNUAL REPORT | 2012-04-27 |
| ANNUAL REPORT | 2011-11-07 |
| ANNUAL REPORT | 2011-10-25 |
| ANNUAL REPORT | 2011-10-22 |
| LC Amendment | 2011-07-21 |
| ANNUAL REPORT | 2011-01-09 |
| ANNUAL REPORT | 2010-06-16 |
| REINSTATEMENT | 2009-09-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
