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NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC - Florida Company Profile

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Company Details

Entity Name: NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 30 Dec 2020 (5 years ago)
Last Event: CONVERSION
Event Date Filed: 30 Dec 2020 (5 years ago)
Document Number: L20000396769
FEI/EIN Number 463756071
Address: 3100 SW 62ND AVE, MIAMI, FL, 33155, US
Mail Address: 3100 SW 62ND AVE, MIAMI, FL, 33155, US
ZIP code: 33155
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
MIAMI CHILDREN'S HEALTH SYSTEM, INC DBA NI Member 3100 SW 62ND AVE, MIAMI, FL, 33155
MIAMI CHILDREN'S HEALTH SYSTEM, INC. Agent C/O LEGAL DEPT, MIAMI, FL, 33155

Unique Entity ID

Unique Entity ID:
ZWT1WL3D17Y5
UEI Expiration Date:
2026-07-01

Business Information

Activation Date:
2025-07-03
Initial Registration Date:
2023-09-21

National Provider Identifier

NPI Number:
1164211934
Certification Date:
2025-07-11

Authorized Person:

Name:
MARCOS MESTRE
Role:
SVP
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Fax:
9549412706

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G25000097697 NICKLAUS CHILDREN'S AT BOCA RATON ACTIVE 2025-08-07 2030-12-31 - 5458 TOWN CENTER ROAD, SUITE #3, BOCA RATON, FL, 33486
G24000129354 NICKLAUS CHILDREN'S AT NAPLES ACTIVE 2024-10-21 2029-12-31 - 15420 COLLIER BLVD, NAPLES, FL, 34120
G24000129380 NICKLAUS CHILDREN'S AT PALM BEACH GARDENS ACTIVE 2024-10-21 2029-12-31 - 11310 LEGACY AVENUE, PALM BEACH GARDENS, FL, 33410
G24000124737 NICKLAUS CHILDREN'S AT WESTON ACTIVE 2024-10-07 2029-12-31 - 2900 SOUTH COMMERCE PARKWAY, WESTON, FL, 33331
G24000084231 NICKLAUS CHILDREN'S AT DAVIE ACTIVE 2024-07-15 2029-12-31 - 10230 W STATE ROAD 84, DAVIE, FL, 33324
G24000082418 NICKLAUS CHILDREN'S AT SOUTH MIAMI ACTIVE 2024-07-10 2029-12-31 - 6262 SUNSET DRIVE, MIAMI, FL, 33143
G24000077397 NICKLAUS CHILDREN'S AT WEST PINES ACTIVE 2024-06-25 2029-12-31 - 18503 PINES BLVD, SUITE 212, PEMBROKE PINES, FL, 33029
G23000076946 NICKLAUS CHILDREN'S AT SUNSET OAKS ACTIVE 2023-06-27 2028-12-31 - 9260 SW 72ND STREET, BUILDING 6, SUITE 217, MIAMI, FL, 33173
G23000072473 NICKLAUS CHILDREN'S AT OVERTOWN ACTIVE 2023-06-14 2028-12-31 - 217 NW 15 STREET, MIAMI, FL, 33136
G23000023723 NICKLAUS CHILDREN'S AT GALLOWAY ACTIVE 2023-02-20 2028-12-31 - 7800 SW 87 AVENUE, #C-350, MIAMI, FL, 33173

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-11 MIAMI CHILDREN'S HEALTH SYSTEM, INC. -
REGISTERED AGENT ADDRESS CHANGED 2024-04-11 C/O LEGAL DEPT, 3100 SW 62ND AVE, MIAMI, FL 33155 -
CONVERSION 2020-12-30 - CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS N12000008352. CONVERSION NUMBER 100000208931

Documents

Name Date
ANNUAL REPORT 2024-04-11
ANNUAL REPORT 2023-02-22
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-04-19
Florida Limited Liability 2020-12-30

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Date of last update: 03 Aug 2025

Sources: Florida Department of State