| Entity Name: | CCR MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Jan 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 31 Aug 2020 (4 years ago) |
| Document Number: | L20000024503 |
| FEI/EIN Number | 84-4521069 |
| Address: | 8150 SW 8th ST, 201, MIAMI, FL 33144 |
| Mail Address: | 8150 SW 8th ST, 201, MIAMI, FL 33144 |
| ZIP code: | 33144 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518598119 | 2020-02-01 | 2024-04-20 | 8150 SW 8TH ST STE 201, MIAMI, FL, 331444273, US | 8150 SW 8TH ST STE 201, MIAMI, FL, 331444273, US | |||||||||||||||||||
|
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| Phone | +1 877-227-6323 |
| Fax | 8888226668 |
Authorized person
| Name | ANGEL MEZA |
| Role | ADMINISTRATOR |
| Phone | 8772276323 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MEZA, ANGEL | Agent | 1065 SW 8th St, 508, MIAMI, FL 33130 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, YURIEN | Manager | 1065 SW 8th St, 508 MIAMI, FL 33130 |
| MEZA, ANGEL | Manager | 1065 SW 8th St, 508 Miami, FL 33130 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-05-13 | MEZA, ANGEL | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-21 | 8150 SW 8th ST, 201, MIAMI, FL 33144 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-21 | 8150 SW 8th ST, 201, MIAMI, FL 33144 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-21 | 1065 SW 8th St, 508, MIAMI, FL 33130 | No data |
| LC AMENDMENT | 2020-08-31 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-05-13 |
| ANNUAL REPORT | 2024-04-28 |
| AMENDED ANNUAL REPORT | 2023-08-25 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-04-30 |
| LC Amendment | 2020-08-31 |
| Florida Limited Liability | 2020-01-17 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
