| Entity Name: | M&V SAN JOSE MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 14 Jun 2021 (4 years ago) |
| Document Number: | L19000126317 |
| FEI/EIN Number | 841792900 |
| Address: | 12750 SW 128TH ST, MIAMI, FL, 33186-5380, US |
| Mail Address: | 12750 SW 128TH ST, MIAMI, FL, 33186-5380, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598318495 | 2019-07-19 | 2023-05-09 | 12750 SW 128TH ST STE 108, MIAMI, FL, 331865380, US | 12750 SW 128TH ST STE 108, MIAMI, FL, 331865380, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 786-409-9490 |
| Fax | 7865922008 |
| Phone | +1 786-713-0970 |
Authorized person
| Name | MABEL MARICHAL |
| Role | MGR |
| Phone | 7864099490 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MABEL MARICHAL | Agent | 19960 SW 190 TH ST, MIAMI, FL, 33187 |
| Name | Role | Address |
|---|---|---|
| MARICHAL MABEL | Manager | 19960 SW 190 TH ST, MIAMI, FL, 33187 |
| VELAZQUE JULIE E | Manager | 19960 SW 190 ST, MIAMI, FL, 33187 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-05-11 | 12750 SW 128TH ST, SUITE 108, MIAMI, FL 33186-5380 | No data |
| CHANGE OF MAILING ADDRESS | 2022-05-11 | 12750 SW 128TH ST, SUITE 108, MIAMI, FL 33186-5380 | No data |
| LC AMENDMENT | 2021-06-14 | No data | No data |
| LC AMENDMENT | 2021-04-14 | No data | No data |
| LC AMENDMENT | 2019-05-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-02-27 |
| ANNUAL REPORT | 2022-03-07 |
| LC Amendment | 2021-06-14 |
| LC Amendment | 2021-04-14 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-03-29 |
| LC Amendment | 2019-05-28 |
| Florida Limited Liability | 2019-05-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
