| Entity Name: | SINA MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Jan 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 30 Jun 2021 (4 years ago) |
| Document Number: | L21000022055 |
| FEI/EIN Number | 86-1739925 |
| Address: | 1541 SE 12 AVENUE, HOMESTEAD, FL, 33034, US |
| Mail Address: | 1541 SE 12 AVENUE, HOMESTEAD, FL, 33034, US |
| ZIP code: | 33034 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407439078 | 2021-05-03 | 2023-10-17 | 1541 SE 12TH AVE STE 29, HOMESTEAD, FL, 330342699, US | 1541 SE 12TH AVE STE 29, HOMESTEAD, FL, 330342699, US | |||||||||||||||||||||||||
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| Phone | +1 786-640-1424 |
| Fax | 7866017124 |
Authorized person
| Name | LAZARO A CASTRO |
| Role | PRESIDENT/MANAGER |
| Phone | 7867195201 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QR1100X - Research Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113623100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TROCHE CRUZ ROXANA | Agent | 1541 SE 12 AVENUE, HOMESTEAD, FL, 33034 |
| Name | Role | Address |
|---|---|---|
| TROCHE CRUZ ROXANA | Manager | 13102 SW 132ND TER, HOMESTEAD, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-05-06 | 1541 SE 12 AVENUE, Suite 29, HOMESTEAD, FL 33034 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-08 | 1541 SE 12 AVENUE, Suite 29, HOMESTEAD, FL 33034 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-08 | 1541 SE 12 AVENUE, 28, 29, HOMESTEAD, FL 33034 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-24 | TROCHE CRUZ, ROXANA | No data |
| LC AMENDMENT | 2021-06-30 | No data | No data |
| LC AMENDMENT | 2021-04-09 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-02-06 |
| LC Amendment | 2021-06-30 |
| LC Amendment | 2021-04-09 |
| Florida Limited Liability | 2021-01-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
