| Entity Name: | CENTRUM MEDICAL CENTER - MIAMI GARDENS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Aug 2019 (5 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 01 Dec 2021 (3 years ago) |
| Document Number: | L19000203130 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 4767 NW 183rd Street, Miami Gardens, FL, 33055-2933, US |
| Mail Address: | 4767 NW 183rd Street, Miami Gardens, FL, 33055-2933, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447806286 | 2019-08-16 | 2024-02-27 | 9250 NW 36TH ST STE 420, DORAL, FL, 331782775, US | 4767 NW 183RD ST, MIAMI GARDENS, FL, 330552933, US | |||||||||||||||||||
|
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| Phone | +1 305-266-2929 |
| Fax | 3055796673 |
Authorized person
| Name | GRACIELA V VICTORERO |
| Role | COO |
| Phone | 3052662929 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Rodriquez- Duret Rodolfo | Manager | 4767 NW 183rd Street, Miami Gardens, FL, 330552933 |
| Victorero Graciela | Manager | 4767 NW 183rd Street, Miami Gardens, FL, 330552933 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-08 | 4767 NW 183rd Street, Miami Gardens, FL 33055-2933 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-08 | 4767 NW 183rd Street, Miami Gardens, FL 33055-2933 | No data |
| LC STMNT OF RA/RO CHG | 2021-12-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-12-01 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-12-01 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-04-29 |
| CORLCRACHG | 2021-12-01 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-02-19 |
| Florida Limited Liability | 2019-08-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
