| Entity Name: | EXCELLENCE MEDICAL AND RESEARCH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 Apr 2021 (4 years ago) |
| Document Number: | L21000170740 |
| FEI/EIN Number | 86-3226419 |
| Address: | 111 NW 183rd street, SUITE 206, MIAMI, FL 33169 |
| Mail Address: | 111 NW 183rd ST, Suite 206, Miami Gardens, FL 33169 |
| ZIP code: | 33169 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700596541 | 2022-12-02 | 2022-12-02 | 111 NW 183RD ST STE 206, MIAMI GARDENS, FL, 331694579, US | 111 NW 183RD ST STE 206, MIAMI GARDENS, FL, 331694579, US | |||||||||||||||
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| Phone | +1 786-320-5229 |
| Fax | 7863205279 |
Authorized person
| Name | MIGUEL ANGEL TRUJILLO PEREZ |
| Role | NURSE PRACTITIONER |
| Phone | 7149319877 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| TAX MEDIC CORPORATE SERVICES LLC | Agent |
| Name | Role | Address |
|---|---|---|
| MARTINEZ, ALEXANDER | Authorized Member | 2300 W 84 ST STE 101, HIALEAH, FL 33016 |
| TRUJILLO, MIGUEL A | Authorized Member | 2300 W 84 ST STE 101, HIALEAH, FL 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-06 | 111 NW 183rd street, SUITE 206, MIAMI, FL 33169 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-06 | 111 NW 183rd street, SUITE 206, MIAMI, FL 33169 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-07 | TAX MEDIC CORPORATE SERVICES LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-07 | 7911 NW 72 AVE, SUITE 219B, MEDLEY, FL 33166 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-04-07 |
| Florida Limited Liability | 2021-04-13 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
