| Entity Name: | HIALEAH GARDENS ALF, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 07 Feb 2008 (17 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L08000013785 |
| FEI/EIN Number | 261926574 |
| Address: | 8905 NW 120TH TERRACE, HIALEAH, FL, 33018 |
| Mail Address: | 8905 NW 120TH TERRACE, HIALEAH, FL, 33018 |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699930305 | 2008-07-22 | 2008-07-22 | 8905 NW 120TH TER, HIALEAH GARDENS, FL, 330184166, US | 8905 NW 120TH TER, HIALEAH GARDENS, FL, 330184166, US | |||||||||||||||||||||||||
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| Phone | +1 305-698-6067 |
| Fax | 3056986945 |
Authorized person
| Name | OSVALDO J MEDINA |
| Role | ADMINISTRATOR |
| Phone | 3056986067 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10556 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 143070000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MEDINA OSVALDO J | Agent | 968 IBIS AVENUE, MIAMI SPRINGS, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| MEDINA OSVALDO J | Managing Member | 968 IBIS AVENUE, MIAMI SPRINGS, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-12 |
| ANNUAL REPORT | 2010-03-29 |
| ANNUAL REPORT | 2009-02-11 |
| Florida Limited Liability | 2008-02-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
