| Entity Name: | MGM IPA DADE-001 LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 28 Jun 2013 (12 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L13000093844 |
| FEI/EIN Number | 46-3127992 |
| Address: | 8318 SW 193RD ST., CUTLER BAY, FL 33157 |
| Mail Address: | 8318 SW 193RD ST., CUTLER BAY, FL 33157 |
| ZIP code: | 33157 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619303112 | 2013-09-17 | 2013-09-17 | 8318 SW 193RD ST, CUTLER BAY, FL, 331578085, US | 8318 SW 193RD ST, CUTLER BAY, FL, 331578085, US | |||||||||||||||||||||
|
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| Phone | +1 305-964-5119 |
Authorized person
| Name | MR. MARIO ARMANDO ESPINO JR. |
| Role | CEO/PRESIDENT |
| Phone | 7863951165 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ESPINO, MARIO | Agent | 8318 SW 193RD ST., CUTLER BAY, FL 33157 |
| Name | Role | Address |
|---|---|---|
| ESPINO, MARIO | Managing Member | 8318 SW 193RD ST., CUTLER BAY, FL 33157 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000089179 | COMPLETE CARE CENTERS | EXPIRED | 2013-09-09 | 2018-12-31 | No data | 8318 SW 193RD ST, CUTLER BAY, FL, 33157 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-15 |
| Florida Limited Liability | 2013-06-28 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
