| Entity Name: | FOREVER LIFE HEALTHCARE SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 09 Jan 2018 (7 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L18000008182 |
| Address: | 1070 W 53 ST, HIALEAH, FL, 33012, US |
| Mail Address: | 1070 W 53 ST, HIALEAH, FL, 33012, US |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669980199 | 2018-01-18 | 2018-01-18 | 3900 NW 79TH AVE STE 223, DORAL, FL, 331666546, US | 3900 NW 79TH AVE STE 223, DORAL, FL, 331666546, US | |||||||||||||
|
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| Phone | +1 786-955-5117 |
Authorized person
| Name | MIRIAM RINCON |
| Role | AP |
| Phone | 7864065380 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VELIZ JUAN C | Agent | 1070 W 53 ST, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| LEON INDIRA | Manager | 10066 NW 41 ST, DORAL, FL, 33178 |
| Name | Role | Address |
|---|---|---|
| VELIZ JUAN C | Authorized Person | 1070 W 53 ST, HIALEAH, FL, 33012 |
| AYALA KATLENN | Authorized Person | 85 COUNTRY CLUB DR WEST, DESTIN, FL, 32541 |
| RINCON MIRIAM L | Authorized Person | 2894 W 72 TERR, HIALEAH, FL, 33018 |
| BRICENO MARIANNY D | Authorized Person | 2894 W 72 TERR, HIALEAH, FL, 33018 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2018-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
