| Entity Name: | HORIZON HEALTH SYSTEM, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Dec 2020 (4 years ago) |
| Document Number: | L20000375849 |
| FEI/EIN Number | 85-3909494 |
| Address: | 160 SE 6TH AVE, A1, DELRAY BEACH, FL, 33483, US |
| Mail Address: | 160 SE 6TH AVE, A1, DELRAY BEACH, FL, 33483, US |
| ZIP code: | 33483 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336735786 | 2020-12-18 | 2022-12-07 | 160 SE 6TH AVE STE A1, DELRAY BEACH, FL, 334835264, US | 160 SE 6TH AVE STE A1, DELRAY BEACH, FL, 334835264, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 561-634-8696 |
| Fax | 5616348699 |
Authorized person
| Name | SANDRA ROMO |
| Role | APRN |
| Phone | 5616348696 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109970300 |
| State | FL |
| Issuer | MEDICAID |
| Number | 0044604 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROMO SANDRA | Agent | 160 SE 6TH AVE, DELRAY BEACH, FL, 33483 |
| Name | Role | Address |
|---|---|---|
| ROMO SANDRA APRN | Manager | 160 SE 6TH AVE, DELRAY BEACH, FL, 33483 |
| Name | Role | Address |
|---|---|---|
| ROMO RAQUEL | Authorized Person | 160 SE 6TH AVE, DELRAY BEACH, FL, 33483 |
| BARYSAU HENADZ | Authorized Person | 160 SE 6TH AVE, DELRAY BEACH, FL, 33483 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-24 | 160 SE 6TH AVE, A1, DELRAY BEACH, FL 33483 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-24 | 160 SE 6TH AVE, A1, DELRAY BEACH, FL 33483 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-24 | 160 SE 6TH AVE, A1, DELRAY BEACH, FL 33483 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-24 |
| Florida Limited Liability | 2020-12-01 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
