| Entity Name: | SOL MD HEALTHCARE CENTERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jun 2015 (10 years ago) |
| Document Number: | L15000103148 |
| FEI/EIN Number | 474137513 |
| Address: | 17940 NW 27TH AVE, MIAMI GARDENS, FL, 33056, US |
| Mail Address: | 2436 N FEDERAL HIGHWAY, SUITE 229, LIGHTHOUSE POINT, FL, 33064, US |
| ZIP code: | 33056 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093195240 | 2015-06-03 | 2024-01-09 | 2436 N FEDERAL HWY STE 229, LIGHTHOUSE POINT, FL, 330646854, US | 17940 NW 27TH AVE, MIAMI GARDENS, FL, 330563505, US | |||||||||||||||||||||||||
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| Phone | +1 561-543-0616 |
| Phone | +1 305-621-8899 |
Authorized person
| Name | XUNDA A. GIBSON |
| Role | MEDICAL DIRECTOR |
| Phone | 3056218899 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME89553 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021304900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GIBSON XUNDA AMD | Agent | 2436 N FEDERAL HIGHWAY, LIGHTHOUSE POINT, FL, 33064 |
| Name | Role | Address |
|---|---|---|
| GIBSON XUNDA AMD | Manager | 2436 N FEDERAL HIGHWAY, LIGHTHOUSE POINT, FL, 33064 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000119031 | SOL MD TRAVEL | ACTIVE | 2023-09-26 | 2028-12-31 | No data | 2436 N FEDERAL HWY, SUITE 229, LIGHTHOUSE POINT, FL, 33064 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-12 | 17940 NW 27TH AVE, MIAMI GARDENS, FL 33056 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-12 | 17940 NW 27TH AVE, MIAMI GARDENS, FL 33056 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-12 | 2436 N FEDERAL HIGHWAY, SUITE 229, LIGHTHOUSE POINT, FL 33064 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-03-17 |
| Florida Limited Liability | 2015-06-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
