| Entity Name: | MIRAMAR PODIATRY AND SURGERY INSTITUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Mar 2006 (19 years ago) |
| Document Number: | L06000029982 |
| FEI/EIN Number | 760827874 |
| Address: | 8910 MIRAMAR PARKWAY, SUITE, 117, MIRAMAR, FL, 33025, US |
| Mail Address: | 8910 MIRAMAR PARKWAY, SUITE, 117, MIRAMAR, FL, 33025, US |
| ZIP code: | 33025 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427166594 | 2006-08-28 | 2012-03-20 | 8910 MIRAMAR PKWY, SUITE 117, MIRAMAR, FL, 330254100, US | 8910 MIRAMAR PKWY, SUITE 117, MIRAMAR, FL, 330254100, US | |||||||||||||||||||||||||
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| Phone | +1 954-442-6100 |
| Fax | 9544426202 |
Authorized person
| Name | DR. NANCY ALEXIS-CALIXTE |
| Role | PODIATRIST |
| Phone | 9544426100 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | PO 3243 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 340589300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CALIXTE HAROLD | Agent | 853 SW 190 Ave, PEMBROKE PINES, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| CALIXTE HAROLD | Managing Member | 853 SW 190 Ave, MIRAMAR, FL, 33029 |
| ALEXIS-CALIXTE NANCY Dr. | Managing Member | 853 SW 190 Ave, PEMBROKE PINES, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-09 | 853 SW 190 Ave, PEMBROKE PINES, FL 33029 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-30 | 8910 MIRAMAR PARKWAY, SUITE, 117, MIRAMAR, FL 33025 | No data |
| CHANGE OF MAILING ADDRESS | 2012-03-30 | 8910 MIRAMAR PARKWAY, SUITE, 117, MIRAMAR, FL 33025 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-03-12 |
| ANNUAL REPORT | 2021-02-27 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-05-08 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-05-24 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
