| Entity Name: | EMMANUEL MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Dec 2010 (14 years ago) |
| Document Number: | L10000127391 |
| FEI/EIN Number | 274986688 |
| Address: | 10404 W flagler street, suite 15, MIAMI, FL, 33174, US |
| Mail Address: | 16134 SW 61 LANE, MIAMI, FL, 33193, US |
| ZIP code: | 33174 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164790986 | 2011-12-07 | 2011-12-07 | 10613 HAMMOCKS BLVD., #212, MIAMI, FL, 33196, US | 10613 HAMMOCKS BLVD., #212, MIAMI, FL, 33196, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 954-424-1873 |
| Fax | 9542007814 |
Authorized person
| Name | DR. JULIAN N GUERRERO |
| Role | MEDICAL DOCTOR |
| Phone | 9544241873 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ACN223 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | AE622Y |
| State | FL |
| Issuer | MEDICAID |
| Number | 278912400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GUERRERO JULIAN N | Agent | 16134 SW 61 LANE, MIAMI, FL, 33193 |
| Name | Role | Address |
|---|---|---|
| GUERRERO JULIAN N | Managing Member | 16134 SW 61 LANE, MIAMI, FL, 33193 |
| GUERRERO LOISA CMGR | Managing Member | 16134 SW 61ST LN, MIAMI, FL, 33193 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-10 | 10404 W flagler street, suite 15, MIAMI, FL 33174 | No data |
| CHANGE OF MAILING ADDRESS | 2014-03-22 | 10404 W flagler street, suite 15, MIAMI, FL 33174 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-03-22 | GUERRERO, JULIAN N | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-22 | 16134 SW 61 LANE, MIAMI, FL 33193 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-01-24 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
