| Entity Name: | ENERGY COMMUNITY MENTAL HEALTH CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
ENERGY COMMUNITY MENTAL HEALTH CLINIC LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 01 Mar 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 12 Aug 2021 (4 years ago) |
| Document Number: | L21000097500 |
| FEI/EIN Number |
862489248
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4995 NW 72nd AVENUE, MIAMI, FL, 33166, US |
| Mail Address: | 4995 NW 72nd AVENUE, MIAMI, FL, 33166, US |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851051262 | 2021-12-27 | 2021-12-27 | 4995 NW 72ND AVE, MIAMI, FL, 331665643, US | 4995 NW 72ND AVE, MIAMI, FL, 331665643, US | |||||||||||||||||||||
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| Phone | +1 786-360-3584 |
| Fax | 7863603867 |
Authorized person
| Name | ERNESTO RODRIGUEZ TANQUERO |
| Role | AUTHORIZED OFFICIAL |
| Phone | 7865200140 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 112486800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ TANQUERO ERNESTO | Authorized Member | 111 SW 113TH AVE, , UNIT 104/8, MIAMI, FL, 33174 |
| RODRIGUEZ TANQUERO ERNESTO | Agent | 4995 NW 72ND AVENUE, MIAMI, FL, 33166 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000019035 | ENERGY MEDICAL CENTER DBA | ACTIVE | 2023-02-08 | 2028-12-31 | - | 2337 W 76TH ST, HIALEAH, FL, 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2021-08-12 | - | - |
| REGISTERED AGENT NAME CHANGED | 2021-08-12 | RODRIGUEZ TANQUERO, ERNESTO | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-08-12 | 4995 NW 72ND AVENUE, STE 102, MIAMI, FL 33166 | - |
| LC AMENDMENT | 2021-06-30 | - | - |
| CHANGE OF MAILING ADDRESS | 2021-06-01 | 4995 NW 72nd AVENUE, STE 102, MIAMI, FL 33166 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-05-08 | 4995 NW 72nd AVENUE, STE 102, MIAMI, FL 33166 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-04-28 |
| LC Amendment | 2021-08-12 |
| Florida Limited Liability | 2021-03-01 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
