| Entity Name: | MIAMI RENAL INSTITUTE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Sep 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 12 Jan 2017 (8 years ago) |
| Document Number: | L15000160611 |
| FEI/EIN Number | 475107245 |
| Address: | 1050 NW 15th Street, Boca Raton, FL, 33486, US |
| Mail Address: | 1050 NW 15th Street, Boca Raton, FL, 33486, US |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487005195 | 2016-06-23 | 2022-07-21 | 2040 NE 163RD ST STE 204, NORTH MIAMI BEACH, FL, 331624953, US | 2040 NE 163RD ST STE 204, NORTH MIAMI BEACH, FL, 331624953, US | |||||||||||||||||||||||||
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| Phone | +1 305-615-1514 |
| Fax | 3055014731 |
Authorized person
| Name | DR. ALI NAYER |
| Role | PRESIDENT |
| Phone | 3056151514 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| License Number | ME103495 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000770700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NAYER ALI | Agent | 1050 NW 15th Street, Boca Raton, FL, 33486 |
| Name | Role | Address |
|---|---|---|
| NAYER ALI | Manager | 1050 NW 15th Street, Boca Raton, FL, 33486 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000143495 | BELLA VITA HEALTHCARE | ACTIVE | 2022-11-18 | 2027-12-31 | No data | 1050 NW 15TH ST, SUITE 111B, BOCA RATON, FL, 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-01 | 1050 NW 15th Street, Suite 111B, Boca Raton, FL 33486 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-01 | 1050 NW 15th Street, Suite 111B, Boca Raton, FL 33486 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-01 | 1050 NW 15th Street, Suite 111B, Boca Raton, FL 33486 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-05 | NAYER, ALI | No data |
| REINSTATEMENT | 2017-01-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-01 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-21 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-01-18 |
| REINSTATEMENT | 2017-01-12 |
| Florida Limited Liability | 2015-09-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
