| Entity Name: | PROFESSIONAL HEALTHCARE ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Mar 2007 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Dec 2019 (5 years ago) |
| Document Number: | L07000031687 |
| FEI/EIN Number | 208742100 |
| Address: | 9299 CORAL REEF DRIVE, SUITE# 203, MIAMI, FL, 33157, US |
| Mail Address: | P.O. BOX 560278, MIAMI, FL, 33256, US |
| ZIP code: | 33157 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760660021 | 2008-02-07 | 2014-10-21 | 8950 SW 57TH AVE, PINECREST, FL, 331562133, US | 8950 SW 57TH AVE, PINECREST, FL, 331562133, US | |||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 305-322-4116 |
| Fax | 3056662252 |
Authorized person
| Name | DR. RICHARD STEVEN PRAGER |
| Role | MANAGING PARTNER |
| Phone | 3053224116 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME45897 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| License Number | ME45897 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME45897 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 372492100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PRAGER RICHARD S | Agent | 8950 SW 57 AVENUE, PINECREST, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| PRAGER RICHARD S | Chief Executive Officer | 8950 SW 57 AVENUE, PINECREST, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| PRAGER LEONOR | Manager | 8950 SW 57 AVENUE, PINECREST, FL, 33156 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2019-12-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-12-02 | PRAGER, RICHARD S | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-16 | 9299 CORAL REEF DRIVE, SUITE# 203, MIAMI, FL 33157 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-12 | 9299 CORAL REEF DRIVE, SUITE# 203, MIAMI, FL 33157 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-23 | 8950 SW 57 AVENUE, PINECREST, FL 33156 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-01-12 |
| ANNUAL REPORT | 2022-03-11 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-04-01 |
| REINSTATEMENT | 2019-12-02 |
| ANNUAL REPORT | 2018-04-15 |
| ANNUAL REPORT | 2017-02-11 |
| ANNUAL REPORT | 2016-02-23 |
| ANNUAL REPORT | 2015-01-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
