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PALM MEDICAL CENTER - AVENTURA, LLC

Company Details

Entity Name: PALM MEDICAL CENTER - AVENTURA, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 08 Jul 2016 (9 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 25 Oct 2024 (3 months ago)
Document Number: L16000126450
FEI/EIN Number 37-1831757
Mail Address: 2600 DOUGLAS RD., SUITE 308, CORAL GABLES, FL 33134
Address: 2600 DOUGLAS RD, SUITE 308, CORAL GABLES, FL 33134
ZIP code: 33134
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1053764829 2016-07-18 2016-07-18 2600 DOUGLAS ROAD, PH7, CORAL GABLES, FL, 33134, US 16241 BISCAYNE BLVD, AVENTURA, FL, 331604300, US

Contacts

Phone +1 305-913-9444
Fax 3054421198
Phone +1 305-947-9414
Fax 3058032389

Authorized person

Name SANTIAGO MOISES MARTIN
Role VICE PRESIDENT OF OPERATIONS
Phone 7863624173

Taxonomy

Taxonomy Code 261Q00000X - Clinic/Center
Is Primary Yes

Agent

Name Role
CORPORATE CREATIONS NETWORK INC. Agent

Executive Producer

Name Role Address
LEAL, JUAN Executive Producer 2600 DOUGLAS RD, SUITE 308 CORAL GABLES, FL 33134

Chief Executive Officer

Name Role Address
CHOUDHRY, FOWAD Chief Executive Officer 2600 DOUGLAS RD., SUITE 308 CORAL GABLES, FL 33134

Chief Operating Officer

Name Role Address
CASILLAS, PATRICIO Chief Operating Officer 2600 DOUGLAS RD., SUITE 308 CORAL GABLES, FL 33134

Vice President

Name Role Address
LEAL, JUAN Vice President 2600 DOUGLAS RD, SUITE 308 CORAL GABLES, FL 33134

Founder

Name Role Address
LEAL, JUAN Founder 2600 DOUGLAS RD, SUITE 308 CORAL GABLES, FL 33134

Administrator

Name Role Address
LEAL, JUAN Administrator 2600 DOUGLAS RD, SUITE 308 CORAL GABLES, FL 33134

Events

Event Type Filed Date Value Description
LC AMENDMENT 2024-10-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2024-10-25 2600 DOUGLAS RD, SUITE 308, CORAL GABLES, FL 33134 No data
REGISTERED AGENT NAME CHANGED 2024-07-26 CORPORATE CREATIONS NETWORK INC. No data
REGISTERED AGENT ADDRESS CHANGED 2024-07-26 801 US HIGHWAY 1, NORTH PALM BEACH, FL 33408 No data
CHANGE OF MAILING ADDRESS 2018-01-23 2600 DOUGLAS RD, SUITE 308, CORAL GABLES, FL 33134 No data

Documents

Name Date
LC Amendment 2024-10-25
Reg. Agent Change 2024-07-26
ANNUAL REPORT 2024-04-04
AMENDED ANNUAL REPORT 2023-10-16
ANNUAL REPORT 2023-01-19
AMENDED ANNUAL REPORT 2022-03-31
ANNUAL REPORT 2022-01-04
ANNUAL REPORT 2021-01-14
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-02-08

Date of last update: 19 Jan 2025

Sources: Florida Department of State