| Entity Name: | MEDSTATION MIAMI PRIMARY CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MEDSTATION MIAMI PRIMARY CARE LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 04 Aug 2016 (9 years ago) |
| Document Number: | L16000145942 |
| FEI/EIN Number |
81-3493088
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3404 N ANDREWS AVE EXT, POMPANO BEACH, FL, 33064, US |
| Mail Address: | 3404 N ANDREWS AVE EXT, POMPANO BEACH, FL, 33064, US |
| ZIP code: | 33064 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548716657 | 2016-08-29 | 2016-08-29 | 6701 SUNSET DR, SUITE # 112, SOUTH MIAMI, FL, 331434529, US | 6701 SUNSET DR, SUITE # 112, SOUTH MIAMI, FL, 331434529, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-667-1511 |
| Fax | 3055038955 |
Authorized person
| Name | THIERRY O. JACQUEMIN |
| Role | MANAGEER MEMBER |
| Phone | 3056671511 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | OS9856 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001536700 |
| State | FL |
| Issuer | NPI INDIVIDUAL |
| Number | 1750407086 |
| State | FL |
| Name | Role |
|---|---|
| BRAZILIAN CLINIC LLC | Authorized Member |
| CSG - CAPITAL SERVICES GROUP, INC. | Agent |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-09-02 | 3404 N ANDREWS AVE EXT, POMPANO BEACH, FL 33064 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-03 | 3404 N ANDREWS AVE EXT, POMPANO BEACH, FL 33064 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-22 | 1191 E NEWPORT CENTER DR SUITE 103, DEERFIELD BEACH, FL 33442 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| AMENDED ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2023-03-01 |
| AMENDED ANNUAL REPORT | 2022-09-08 |
| AMENDED ANNUAL REPORT | 2022-08-10 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-03-17 |
| AMENDED ANNUAL REPORT | 2020-06-24 |
| AMENDED ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2020-01-22 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
