| Entity Name: | CONSTELLATION MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 May 2020 (5 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 11 May 2020 (5 years ago) |
| Document Number: | L20000123073 |
| FEI/EIN Number | 85-1319619 |
| Address: | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| Mail Address: | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225794852 | 2021-11-09 | 2022-02-09 | 1205 SW 37TH AVE, MIAMI, FL, 331354226, US | 1850 NE 163RD ST, NORTH MIAMI BEACH, FL, 331624867, US | |||||||||||||||||
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| Phone | +1 786-552-7800 |
Authorized person
| Name | DR. NICOLAS ALVAREZ |
| Role | CEO |
| Phone | 7865527800 |
Taxonomy
| Taxonomy Code | 207QG0300X - Geriatric Medicine (Family Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CONSTELLATION MEDICAL GROUP LLC - 401(K) | 2023 | 851319619 | 2024-09-27 | CONSTELLATION MEDICAL GROUP LLC | 3 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-27 |
| Name of individual signing | BEATRIZ ECHEMENDIA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-09-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 7863446434 |
| Plan sponsor’s address | 1205 SW 37TH AVE, CORAL GABLES, FL, 33135 |
Signature of
| Role | Plan administrator |
| Date | 2024-09-27 |
| Name of individual signing | BEATRIZ ECHEMENDIA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-09-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 7863446434 |
| Plan sponsor’s address | 1205 SW 37TH AVE, CORAL GABLES, FL, 33135 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-27 |
| Name of individual signing | BEATRIZ ECHEMENDIA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-09-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 7863446434 |
| Plan sponsor’s address | 1205 SW 37TH AVE, CORAL GABLES, FL, 33135 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-27 |
| Name of individual signing | BEATRIZ ECHEMENDIA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ALVAREZ, NICOLAS R, MD | Agent | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ, NICOLAS R, MD | Manager | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| REGALADO, ELDA, MD | Manager | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| GARCIA-HERRAN, MANUEL, MD | Manager | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| Garcia, Osvaldo | Manager | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| Alvarez, Claudio R | Manager | 1205 SW 37TH AVE., MIAMI, FL 33135 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000033036 | CONSTELLATION MEDICAL GROUP DBA HEALTH MEDICAL CENTER-MIAMI LAKES | ACTIVE | 2022-03-14 | 2027-12-31 | No data | 15600 NW 67TH AVE SUITE 105, MIAMI, FL, 33014 |
| G22000032991 | ONE HEALTH MEDICAL CENTER - FLAGLER | ACTIVE | 2022-03-14 | 2027-12-31 | No data | 85 GRAND CANAL DRIVE,SUITE 203, MIAMI, FL, 33144 |
| G22000032994 | ONE HEALTH MEDICAL CENTER - NORTH MIAMI | ACTIVE | 2022-03-14 | 2027-12-31 | No data | 1850 NE 163 STREET, NORTH MIAMI BEACH, FL, 33162 |
| G20000113440 | SOLERA HEALTH SYSTEMS - FLAGLER | ACTIVE | 2020-09-01 | 2025-12-31 | No data | 1205 SW 37TH AVENUE, MIAMI, FL, 33135 |
| G20000113442 | SOLERA HEALTH SYSTEMS - NORTH MIAMI | ACTIVE | 2020-09-01 | 2025-12-31 | No data | 1205 SW 37TH AVENUE, MIAMI, FL, 33135 |
| G20000113447 | SOLERA HEALTH SYSTEMS - MIAMI LAKES | ACTIVE | 2020-09-01 | 2025-12-31 | No data | 1205 SW 37TH AVENUE, MIAMI, FL, 33135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-11-09 | ALVAREZ, NICOLAS R, MD | No data |
| MERGER | 2020-05-11 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 3. MERGER NUMBER 100000202601 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-24 |
| AMENDED ANNUAL REPORT | 2022-11-09 |
| ANNUAL REPORT | 2022-05-16 |
| ANNUAL REPORT | 2021-02-12 |
| Florida Limited Liability | 2020-05-11 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
