| Entity Name: | AZUCAR ADULT DAY CARE, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Jun 2012 (13 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 08 Nov 2021 (3 years ago) |
| Document Number: | L12000083263 |
| FEI/EIN Number | 455598225 |
| Address: | 9254/56 SW 40 Street, MIAMI, FL, 33165, US |
| Mail Address: | 4121 SW 96 Avenue, MIAMI, FL, 33165, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396088936 | 2013-04-02 | 2013-04-02 | 8655 SW 24TH ST, SUITE C, MIAMI, FL, 331552337, US | 8655 SW 24TH ST, SUITE C, MIAMI, FL, 331552337, US | |||||||||||||||||||||||||
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| Phone | +1 305-815-8367 |
| Fax | 3057482544 |
Authorized person
| Name | MS. LISSETTE GANCEDO |
| Role | ADMINISTRATOR |
| Phone | 3058158367 |
Taxonomy
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| License Number | 9235 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AGENCY FOR HEALTH CARE ADMINISTRATION- DIVISION OF HEALTH QUALITY ASSURANCE |
| Number | 9235 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gancedo Lissette | Agent | 4121 SW 96 Avenue, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| GANCEDO LISSETTE | Managing Member | 4121 SW 96 AVE, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-10-11 | 9254/56 SW 40 Street, MIAMI, FL 33165 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-10-11 | 4121 SW 96 Avenue, MIAMI, FL 33165 | No data |
| LC AMENDMENT | 2021-11-08 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | 9254/56 SW 40 Street, MIAMI, FL 33165 | No data |
| LC AMENDMENT | 2016-08-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-21 | Gancedo, Lissette | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| AMENDED ANNUAL REPORT | 2023-10-11 |
| ANNUAL REPORT | 2023-09-09 |
| ANNUAL REPORT | 2022-02-17 |
| LC Amendment | 2021-11-08 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-01-26 |
| ANNUAL REPORT | 2017-03-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
