| Entity Name: | PURE EXECUTIVE HEALTH & WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PURE EXECUTIVE HEALTH & WELLNESS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 03 Jun 2013 (12 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 16 Nov 2015 (9 years ago) |
| Document Number: | L13000079621 |
| FEI/EIN Number |
30-0785533
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4100 Salzedo St, Coral Gables, FL, 33146, US |
| Mail Address: | 4100 Salzedo St, Coral Gables, FL, 33146, US |
| ZIP code: | 33146 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932540036 | 2013-07-17 | 2013-10-10 | 11921 S DIXIE HWY, SUITE 201, MIAMI, FL, 331564449, US | 11921 S DIXIE HWY, SUITE 201, MIAMI, FL, 331564449, US | |||||||||||||||||||
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| Phone | +1 786-227-6811 |
| Fax | 7867322377 |
Authorized person
| Name | DR. JENNIFER MIRANDA |
| Role | MEDICAL DIRECTOR |
| Phone | 7862276811 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME106748 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PURE EXECUTIVE HEALTH & WELLNESS, LLC CASH BALANCE PLAN | 2023 | 300785533 | 2024-10-14 | PURE EXECUTIVE HEALTH & WELLNESS, LLC | 7 | |||||||||||||||||||||||||||||||
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| PURE EXECUTIVE HEALTH & WELLNESS LLC GHT BENEFIT PLAN | 2023 | 300785533 | 2025-01-30 | PURE EXECUTIVE HEALTH & WELLNESS LLC | 4 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 851828091 |
| Plan administrator’s name | MARILU RIOS |
| Plan administrator’s address | 1 SE 3RD AVENUE, SUITE 1410, MIAMI, FL, 33131 |
| Administrator’s telephone number | 3053507700 |
Signature of
| Role | Plan administrator |
| Date | 2025-01-30 |
| Name of individual signing | MARILU RIOS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 7862276811 |
| Plan sponsor’s address | 4100 SALZEDO STREET, SUITE 4, CORAL GABLES, FL, 33416 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 7862276811 |
| Plan sponsor’s address | 4100 SALZEDO STREET, SUITE 4, CORAL GABLEX, FL, 33416 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-27 |
| Name of individual signing | DUSTIN MANGAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MIRANDA-MANGAS JENNIFER | Agent | 5881 SW 49th St, Miami, FL, 33155 |
| JENNIFER MIRANDA MD, LLC | Manager | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-21 | 5881 SW 49th St, Miami, FL 33155 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2016-02-12 | 4100 Salzedo St, STE 4, Coral Gables, FL 33146 | - |
| CHANGE OF MAILING ADDRESS | 2016-02-12 | 4100 Salzedo St, STE 4, Coral Gables, FL 33146 | - |
| LC AMENDMENT | 2015-11-16 | - | - |
| REGISTERED AGENT NAME CHANGED | 2015-11-16 | MIRANDA-MANGAS, JENNIFER | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-06-11 |
| ANNUAL REPORT | 2023-05-24 |
| ANNUAL REPORT | 2022-05-18 |
| ANNUAL REPORT | 2021-07-26 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-02-12 |
| LC Amendment | 2015-11-16 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6859797106 | 2020-04-14 | 0455 | PPP | 4100 Salzedo St #4, CORAL GABLES, FL, 33146-1008 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
