| Entity Name: | MIAMI LAKES PEDIATRICS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MIAMI LAKES PEDIATRICS, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 13 Jul 2018 (7 years ago) |
| Document Number: | L18000169630 |
| FEI/EIN Number |
83-1306496
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 14400 NW 77 CT., SUITE 102, MIAMI LAKES, FL, 33016, US |
| Mail Address: | 14400 NW 77 CT., SUITE 102, MIAMI LAKES, FL, 33016, US |
| ZIP code: | 33016 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083202550 | 2021-01-09 | 2021-01-09 | 14400 NW 77TH CT STE 102, MIAMI LAKES, FL, 330161590, US | 1199 W FLAGLER ST STE 10, MIAMI, FL, 331301055, US | |||||||||||||||||||||||
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| Phone | +1 305-823-7768 |
| Fax | 3058232211 |
| Phone | +1 305-326-8887 |
Authorized person
| Name | CRISTINA ALFONSO |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 3058237768 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103180601 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAPOTE MAYRA F | Authorized Member | 14400 NW 77 CT. SUITE 102, MIAMI LAKES, FL, 33016 |
| CAPOTE MAYRA F | Agent | 14400 NW 77 CT., MIAMI LAKES, FL, 33016 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-31 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-02-18 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-04-24 |
| Florida Limited Liability | 2018-07-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4593327206 | 2020-04-27 | 0455 | PPP | 14400 NW 77TH COURT, MIAMI LAKES, FL, 33016 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 May 2025
Sources: Florida Department of State
