| Entity Name: | RHEMA FAMILY PRACTICE PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Nov 2020 (4 years ago) |
| Document Number: | L20000349808 |
| FEI/EIN Number | 85-4012037 |
| Address: | 10305 NW 6TH STREET, PLANTATION, FL, 33324, US |
| Mail Address: | 10305 NW 6TH STREET, PLANTATION, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508461252 | 2020-12-01 | 2020-12-01 | 10305 NW6TH STREET,PLANTATION.FL-33324, PLANTATION, FL, 33324, US | 10305 NW 6TH ST, PLANTATION, FL, 333241617, US | |||||||||||||||||||||||||
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| Phone | +1 754-246-8414 |
Authorized person
| Name | BEENA K BIJOY |
| Role | ARNP., FNP BC |
| Phone | 7542468414 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | L20000349808 |
| State | FL |
| Issuer | NON INSURER |
| Number | L20000349808 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BIJOY BEENA | Agent | 10305 NW 6TH STREET, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| BIJOY BEENA | Authorized Member | 10305 NW 6TH STREET, PLANTATION, FL, 33324 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-24 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-05-02 |
| Florida Limited Liability | 2020-11-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
