| Entity Name: | INTEGRA DIALYSIS CENTER LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Jan 2017 (8 years ago) |
| Document Number: | L17000011837 |
| FEI/EIN Number | 81-5043959 |
| Address: | 1490 W 49 Place, 201, Hialeah, FL 33012 |
| Mail Address: | 1490 W 49 Place, 201, Hialeah, FL 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801438130 | 2019-10-08 | 2019-10-08 | 6100 SW 183RD WAY, SOUTHWEST RANCHES, FL, 333311640, US | 1490 W 49TH PL, HIALEAH, FL, 330123148, US | |||||||||||||
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| Phone | +1 954-274-6045 |
Authorized person
| Name | SOCORRO MIRYAM MATHEWS |
| Role | ADMINISTRATOR |
| Phone | 9542746045 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MATHEWS, SOCORRO M | Agent | 6100 SW 183RD WAY, FORT LAUDERDALE, FL 33331 |
| Name | Role | Address |
|---|---|---|
| MATHEWS, SOCORRO M | Authorized Member | 6100 SW 183RD WAY, FORT LAUDERDALE, FL 33331 |
| RICH, JEFFREY M | Authorized Member | 6100 SW 183RD WAY, FORT LAUDERDALE, FL 33331 |
| Fadragas, Osmany | Authorized Member | 1490 W 49 Place, 201 Hialeah, FL 33012 |
| Caceres Crespo, Betsy | Authorized Member | 1490 W 49 Place, 201 Hialeah, FL 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-29 | 1490 W 49 Place, 201, Hialeah, FL 33012 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-29 | 1490 W 49 Place, 201, Hialeah, FL 33012 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-16 |
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2018-04-30 |
| Florida Limited Liability | 2017-01-19 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
