| Entity Name: | LEIVA MEDICAL APRN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Jul 2021 (4 years ago) |
| Document Number: | L21000305164 |
| FEI/EIN Number | 87-1714390 |
| Address: | 8265 NW 41 St, Doral, FL, 33166, US |
| Mail Address: | 8265 NW 41 St, Doral, FL, 33166, US |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578221057 | 2021-12-02 | 2021-12-02 | 10030 SW 40TH ST STE A, MIAMI, FL, 331653994, US | 10030 SW 40TH ST STE A, MIAMI, FL, 331653994, US | |||||||||||||
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| Phone | +1 786-366-1153 |
Authorized person
| Name | CARLOS LEIVA |
| Role | OWNER |
| Phone | 7863661153 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LEIVA CARLOS E | Agent | 8265 NW 41 St, Doral, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| LEIVA CARLOS E | President | 8265 NW 41 St, Doral, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-08 | 8265 NW 41 St, Apt 203, Doral, FL 33166 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-08 | 8265 NW 41 St, Apt 203, Doral, FL 33166 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-08 | 8265 NW 41 St, Apt 203, Doral, FL 33166 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-03-07 |
| Florida Limited Liability | 2021-07-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
