| Entity Name: | CARE OPTIMUM FAMILY HEALTH SERVICES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 21 Jul 2014 (11 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L14000114475 |
| FEI/EIN Number | 47-1375480 |
| Address: | 4651 SHERIDAN STREET, HOLLYWOOD, FL, 33021, US |
| Mail Address: | 4651 SHERIDAN STREET, HOLLYWOOD, FL, 33021, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265834881 | 2014-09-25 | 2014-09-25 | 4651 SHERIDAN ST, SUITE 250, HOLLYWOOD, FL, 330213457, US | 4651 SHERIDAN ST, SUITE 250, HOLLYWOOD, FL, 330213457, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 754-210-7919 |
| Fax | 7542107918 |
Authorized person
| Name | LINDA JEAN |
| Role | FAMILY MEDICINE PHYSICIAN |
| Phone | 7862629007 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME114969 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009141400 |
| State | FL |
| Issuer | MEDICARE |
| Number | HJ886Z |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JEAN LINDA D | Agent | 4651 SHERIDAN STREET, HOLLYWOOD, FL, 33021 |
| Name | Role | Address |
|---|---|---|
| JEAN LINDA D | Manager | 4651 SHERIDAN STREET SUITE 250, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-22 | 4651 SHERIDAN STREET, STE 250, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-22 | 4651 SHERIDAN STREET, STE 250, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-22 | 4651 SHERIDAN STREET, STE 250, HOLLYWOOD, FL 33021 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-23 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-02-22 |
| Florida Limited Liability | 2014-07-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
