| Entity Name: | LA UNION MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 18 May 2017 (8 years ago) |
| Date of dissolution: | 25 Feb 2020 (5 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 25 Feb 2020 (5 years ago) |
| Document Number: | L17000109236 |
| Address: | 620 NW 33 AVE., MIAMI, FL 33125 |
| Mail Address: | 620 NW 33 AVE., MIAMI, FL 33125 |
| ZIP code: | 33125 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245793462 | 2019-04-14 | 2019-04-14 | 620 NW 33RD AVE, MIAMI, FL, 331254106, US | 620 NW 33RD AVE, MIAMI, FL, 331254106, US | |||||||||||||||||||||
|
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| Phone | +1 305-456-8366 |
| Fax | 3054565900 |
Authorized person
| Name | JORGE PEREZ |
| Role | AMBR |
| Phone | 3054568366 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000000000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEREZ, JORGE | Agent | 620 NW 33 AVE., MIAMI, FL 33125 |
| Name | Role | Address |
|---|---|---|
| PEREZ, JORGE | Authorized Member | 620 NW 33 AVE., MIAMI, FL 33125 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000108433 | LA UNION MEDICAL CENTER | EXPIRED | 2018-10-04 | 2023-12-31 | No data | 620 NW 33 AVE, MIAMI, FL, 33125 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2020-02-25 | No data | No data |
| LC AMENDMENT | 2019-06-27 | No data | No data |
| LC NAME CHANGE | 2018-11-27 | LA UNION MEDICAL CENTER LLC | No data |
| LC AMENDMENT | 2018-10-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-10-03 | 620 NW 33 AVE., MIAMI, FL 33125 | No data |
| CHANGE OF MAILING ADDRESS | 2018-10-03 | 620 NW 33 AVE., MIAMI, FL 33125 | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2020-02-25 |
| LC Amendment | 2019-06-27 |
| ANNUAL REPORT | 2019-03-20 |
| LC Name Change | 2018-11-27 |
| LC Amendment | 2018-10-03 |
| ANNUAL REPORT | 2018-04-30 |
| Florida Limited Liability | 2017-05-18 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
