| Entity Name: | OPTIMUM CARE MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Aug 2019 (5 years ago) |
| Document Number: | L19000218789 |
| FEI/EIN Number | 84-2975800 |
| Address: | 3908 SW 137th Ave, Davie, FL, 33330, US |
| Mail Address: | 4581 Weston Rd #381, Weston, FL, 33331, US |
| ZIP code: | 33330 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962053728 | 2019-09-24 | 2022-11-22 | 10312 BLOOMINGDALE AVE, STE 108 PMB 339, RIVERVIEW, FL, 335783603, US | 3908 SW 137TH AVE, DAVIE, FL, 333305712, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 786-470-0024 |
| Fax | 7866521372 |
| Fax | 9548062484 |
Authorized person
| Name | RONOEL PENALVER |
| Role | PHYSICIAN/OWNER |
| Phone | 7864700024 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 282N00000X - General Acute Care Hospital |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PENALVER RONOEL | Agent | 4581 Weston Rd, Weston, FL, 33330 |
| Name | Role | Address |
|---|---|---|
| PENALVER RONOEL Dr. | President | 4581 Weston Rd, Weston, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-03 | 3908 SW 137th Ave, Davie, FL 33330 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-03 | 4581 Weston Rd, #381, Weston, FL 33330 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-14 | 3908 SW 137th Ave, Davie, FL 33330 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-01-15 |
| Florida Limited Liability | 2019-08-27 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
