| Entity Name: | COMPLETE CARE MANAGEMENT SERVICES ACO, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Sep 2017 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Dec 2021 (3 years ago) |
| Document Number: | L17000202209 |
| FEI/EIN Number | 82-3310612 |
| Address: | 2901 SW 149th Avenue, Miramar, FL, 33027, US |
| Mail Address: | 2901 SW 149th Avenue, Miramar, FL, 33027, US |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780197152 | 2017-11-08 | 2023-03-22 | 6625 MIAMI LAKES DR STE 247, MIAMI LAKES, FL, 330142768, US | 6625 MIAMI LAKES DR STE 247, MIAMI LAKES, FL, 330142768, US | |||||||||||||||||||||||
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| Phone | +1 786-292-4797 |
| Fax | 8663179048 |
Authorized person
| Name | MR. MARIO ARMANDO ESPINO JR. |
| Role | FOUNDER-COB |
| Phone | 7863951165 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Espino Mario A | Agent | 15501 NW 88th Ave, Hialeah, FL, 330181338 |
| Name | Role | Address |
|---|---|---|
| Espino Gladys | Chief Operating Officer | 15501 NW 88th Ave, Hialeah, FL, 330181338 |
| Name | Role | Address |
|---|---|---|
| Espino Mario | Manager | 15501 NW 88TH AVE, MIAMI LAKES, FL, 330181338 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000034015 | MDSONDEMAND | ACTIVE | 2020-03-19 | 2025-12-31 | No data | 18260 NE 19 AVE SUITE 202, NORTH MIAMI BEACH, FL, 33162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-08 | 2901 SW 149th Avenue, SUITE 303, Miramar, FL 33027 | No data |
| CHANGE OF MAILING ADDRESS | 2024-08-08 | 2901 SW 149th Avenue, SUITE 303, Miramar, FL 33027 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-09 | 15501 NW 88th Ave, Hialeah, FL 33018-1338 | No data |
| REINSTATEMENT | 2021-12-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-12-01 | Espino, Mario A | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2018-11-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-08-09 |
| AMENDED ANNUAL REPORT | 2024-08-08 |
| ANNUAL REPORT | 2024-03-09 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-03-09 |
| REINSTATEMENT | 2021-12-01 |
| AMENDED ANNUAL REPORT | 2020-07-16 |
| AMENDED ANNUAL REPORT | 2020-05-27 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-02-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
