| Entity Name: | SUPERHERO KIDS PPEC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Sep 2020 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 17 Dec 2021 (3 years ago) |
| Document Number: | L20000288360 |
| FEI/EIN Number | 86-1244506 |
| Address: | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 |
| Mail Address: | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851044168 | 2022-01-27 | 2022-01-27 | 1700 W WOOLBRIGHT RD STE 3, BOYNTON BEACH, FL, 334266346, US | 1700 W WOOLBRIGHT RD STE 3, BOYNTON BEACH, FL, 334266346, US | |||||||||||||||||||||||||
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| Phone | +1 561-877-2152 |
| Fax | 5618104197 |
Authorized person
| Name | KELSEY ALLEN |
| Role | OWNER ADMINISTRATOR |
| Phone | 5618772152 |
Taxonomy
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 3140N1450X - Pediatric Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA PPEC LICENSE |
| Number | 60081108 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VIERA, ERNESTO C | Agent | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 |
| Name | Role | Address |
|---|---|---|
| VIERA, ERNESTO C | Manager | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 |
| ALLEN, KELSEY | Manager | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 |
| VIERA, CARLOS F | Manager | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2021-12-17 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-12-17 | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 | No data |
| CHANGE OF MAILING ADDRESS | 2021-12-17 | 1700 WOOLBRIGHT RD STE #3, BOYNTON BEACH, FL 33426 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-18 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-24 |
| LC Amendment | 2021-12-17 |
| ANNUAL REPORT | 2021-04-09 |
| Florida Limited Liability | 2020-09-15 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
