| Entity Name: | FALCON HEALTHCARE AGENCY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Dec 2020 (4 years ago) |
| Document Number: | L20000379402 |
| FEI/EIN Number | 854275035 |
| Address: | 2901 Nw 62 street, ft lauderdale, FL, 33309, US |
| Mail Address: | 2901 Nw 62 street, ft lauderdale, FL, 33309, US |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275267437 | 2022-07-13 | 2023-09-01 | 2901 NW 62ND ST STE 105A, FORT LAUDERDALE, FL, 333091730, US | 2901 NW 62ND ST STE 105A, FORT LAUDERDALE, FL, 333091730, US | |||||||||||||||||||||||||
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| Phone | +1 954-477-4591 |
| Fax | 9544774592 |
Authorized person
| Name | MS. PHALONNE BURIN |
| Role | ADMINISTRATOR |
| Phone | 9544774591 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA LICENSE NURSE REGISTRY |
| Number | 30212266 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| burin phalonne | Agent | 5860 south sable circle, margate, FL, 33063 |
| Name | Role | Address |
|---|---|---|
| FRAGE GUERDY | Authorized Person | 5860 SOUTH SABLE CIRCLE, MARGATE, FL, 33063 |
| Name | Role | Address |
|---|---|---|
| BURIN PHALONNE | Authorized Member | 5860 SOUTH SABLE CIRCLR, MARGATE, FL, 33063 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-14 | 2901 Nw 62 street, 105A, ft lauderdale, FL 33309 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-14 | 2901 Nw 62 street, 105A, ft lauderdale, FL 33309 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-06-01 | burin, phalonne | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-06-01 | 5860 south sable circle, margate, FL 33063 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-12 |
| AMENDED ANNUAL REPORT | 2021-06-01 |
| AMENDED ANNUAL REPORT | 2021-05-27 |
| ANNUAL REPORT | 2021-04-12 |
| Florida Limited Liability | 2020-12-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
