| Entity Name: | MIAMI CENTER OF EXCELLENCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Mar 2018 (7 years ago) |
| Document Number: | L18000073874 |
| FEI/EIN Number | 82-5025652 |
| Address: | 7775 SW 87TH AVENUE, STE 100, MIAMI, FL, 33173, US |
| Mail Address: | 7775 SW 87TH AVENUE, STE 100, MIAMI, FL, 33173, US |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437655545 | 2018-04-05 | 2018-11-20 | 8700 N KENDALL DR STE 208, MIAMI, FL, 331762206, US | 8700 N KENDALL DR STE 208, MIAMI, FL, 331762206, US | |||||||||||||||||||||
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| Phone | +1 305-274-3130 |
| Fax | 3052741699 |
Authorized person
| Name | ISAAC RUIZ |
| Role | OFFICE MANAGER |
| Phone | 3055155425 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001447900 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIAMI CENTER OF EXCELLENCE LLC 401(K) PROFIT SHARING PLAN & TRUST | 2019 | 825025652 | 2020-08-13 | MIAMI CENTER OF EXCELLENCE LLC | 23 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2020-08-13 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 3052743130 |
| Plan sponsor’s address | 3225 AVIATION AVE STE 700, MIAMI, FL, 331334741 |
Plan administrator’s name and address
| Administrator’s EIN | 264477125 |
| Plan administrator’s name | 401K GENERATION |
| Plan administrator’s address | 195 INTERNATIONAL PKWY, S #311, LAKE MARY, FL, 32746 |
| Administrator’s telephone number | 8669985879 |
Signature of
| Role | Plan administrator |
| Date | 2019-06-06 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HILL WALLACE AUDRA | Agent | 102411 OVERSEAS HIGHWAY, KEY LARGO, FL, 33037 |
| Name | Role | Address |
|---|---|---|
| FINK RANDY A | Authorized Member | 2874 STRATTON WOODS VIEW, COLORADO SPRINGS, CO, 80906 |
| Name | Role | Address |
|---|---|---|
| FINK STEPHANIE J | Member | 2874 STRATTON WOODS VIEW, COLORADO SPRINGS, CO, 80906 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-30 | 7775 SW 87TH AVENUE, STE 100, MIAMI, FL 33173 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | 7775 SW 87TH AVENUE, STE 100, MIAMI, FL 33173 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-30 | HILL WALLACE, AUDRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-30 | 102411 OVERSEAS HIGHWAY, KEY LARGO, FL 33037 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-11 |
| ANNUAL REPORT | 2019-04-25 |
| Florida Limited Liability | 2018-03-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
