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CHEN NEIGHBORHOOD MEDICAL OF NORTH LAKELAND, LLC

Company Details

Entity Name: CHEN NEIGHBORHOOD MEDICAL OF NORTH LAKELAND, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 01 Mar 2016 (9 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 07 Jun 2022 (3 years ago)
Document Number: L16000043355
FEI/EIN Number 61-1786637
Address: 1395 NW 167th St, Miami Gardens, FL 33169
Mail Address: 1395 NW 167th St, Miami Gardens, FL 33169
ZIP code: 33169
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1407218043 2016-03-23 2016-06-01 1395 NW 167TH ST, MIAMI GARDENS, FL, 331695742, US 206 N FLORIDA AVE, LAKELAND, FL, 338014902, US

Contacts

Phone +1 305-628-6117

Authorized person

Name CHRISTOPHER CHEN
Role CHIEF EXECUTIVE OFFICER
Phone 3058314760

Taxonomy

Taxonomy Code 174400000X - Specialist
Is Primary Yes
Taxonomy Code 332900000X - Non-Pharmacy Dispensing Site
Is Primary No

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

Manager

Name Role Address
CHEN, CHRISTOPHER Manager 1395 NW 167th St, Miami Gardens, FL 33169

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000100820 DEDICATED SENIOR MEDICAL CENTER ACTIVE 2016-09-14 2026-12-31 No data 1395 NW 167TH STREET, MIAMI, FL, 33169
G16000055754 DEDICATED SENIOR HEALTHCARE ACTIVE 2016-06-06 2026-12-31 No data 1395 NW 167TH STREET, MIAMI, FL, 33169

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-04-19 1395 NW 167th St, Miami Gardens, FL 33169 No data
CHANGE OF MAILING ADDRESS 2023-04-19 1395 NW 167th St, Miami Gardens, FL 33169 No data
LC STMNT OF RA/RO CHG 2022-06-07 No data No data
REGISTERED AGENT NAME CHANGED 2022-06-07 CORPORATION SERVICE COMPANY No data
REGISTERED AGENT ADDRESS CHANGED 2022-06-07 1201 HAYS STREET, TALLAHSSEE, FL 32301 No data

Documents

Name Date
ANNUAL REPORT 2024-04-17
ANNUAL REPORT 2023-04-19
CORLCRACHG 2022-06-07
ANNUAL REPORT 2022-04-29
ANNUAL REPORT 2021-04-05
ANNUAL REPORT 2020-03-16
AMENDED ANNUAL REPORT 2019-11-01
ANNUAL REPORT 2019-04-08
ANNUAL REPORT 2018-04-13
ANNUAL REPORT 2017-04-29

Date of last update: 20 Jan 2025

Sources: Florida Department of State