| Entity Name: | EXCELLENT MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Mar 2018 (7 years ago) |
| Document Number: | L18000068815 |
| FEI/EIN Number | 824847516 |
| Address: | 13155 SW 134th Street, Miami, FL, 33186-4489, US |
| Mail Address: | 13155 SW 134th Steet, SUITE 224, Miami, FL, 33186-4489, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699279307 | 2018-03-19 | 2023-05-24 | 13155 SW 134TH ST STE 224, MIAMI, FL, 331864489, US | 13155 SW 134TH ST STE 224, MIAMI, FL, 331864489, US | |||||||||||||||||||||||||||
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| Phone | +1 786-864-1030 |
| Fax | 3057357666 |
Authorized person
| Name | MR. ALEXEI GOMEZ |
| Role | PRESIDENT |
| Phone | 7868641030 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOMEZ ALEXEI | Agent | 13155 SW 134th Street, Miami, FL, 331864489 |
| Name | Role | Address |
|---|---|---|
| GOMEZ ALEXEI | President | 13155 SW 134th Steet, Miami, FL, 331864489 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-28 | 13155 SW 134th Street, suite 224, Miami, FL 33186-4489 | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-28 | 13155 SW 134th Street, suite 224, Miami, FL 33186-4489 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-10-28 | 13155 SW 134th Street, suite 224, Miami, FL 33186-4489 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-18 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-02 |
| AMENDED ANNUAL REPORT | 2021-10-28 |
| ANNUAL REPORT | 2021-01-20 |
| ANNUAL REPORT | 2020-01-03 |
| ANNUAL REPORT | 2019-01-14 |
| Florida Limited Liability | 2018-03-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
