| Entity Name: | AMERICAN COMMUNITY HEALTH AND WELLNESS CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Jul 2020 (5 years ago) |
| Document Number: | L20000226150 |
| FEI/EIN Number | 85-2415352 |
| Address: | 3241 NW 7TH ST, MIAMI, FL 33125 |
| Mail Address: | 3241 NW 7TH ST, MIAMI, FL 33125 |
| ZIP code: | 33125 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497366256 | 2020-08-13 | 2021-01-11 | 3241 NW 7TH ST, MIAMI, FL, 331254139, US | 3241 NW 7TH ST, MIAMI, FL, 331254139, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 786-439-8048 |
Authorized person
| Name | MR. JOSE YALIAN BENITEZ |
| Role | OWNER |
| Phone | 7864398048 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 251S00000X |
| State | FL |
| Issuer | MEDICAID |
| Number | 251B00000X |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BENITEZ, JOSE Y | Agent | 9470 SW 10 ST, MIAMI, FL 33174 |
| Name | Role | Address |
|---|---|---|
| BENITEZ, JOSE Y | President | 9470 SW 10 ST, MIAMI, FL 33174 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000140523 | AMERICAN HEALTH CENTERS LLC | ACTIVE | 2022-11-11 | 2027-12-31 | No data | 3241 NW 7TH ST, MIAMI, FL, 33125 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-08 |
| Florida Limited Liability | 2020-07-29 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
