| Entity Name: | ACCESS MEDICAL GROUP OF MARGATE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Apr 2022 (3 years ago) |
| Document Number: | L22000191809 |
| FEI/EIN Number | 882263310 |
| Mail Address: | 7700 FORSYTH BLVD., ST. LOUIS, MO, 63105, US |
| Address: | 6100 BLUE LAGOON DRIVE, MIAMI, FL, 33126, US |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295472066 | 2022-05-13 | 2023-10-20 | 6100 BLUE LAGOON DR STE 365, MIAMI, FL, 331267010, US | 2416 N STATE ROAD 7, MARGATE, FL, 330635720, US | |||||||||||||||||||||||||||||||
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| Phone | +1 786-322-7333 |
| Fax | 7863475022 |
| Phone | +1 954-779-5610 |
| Fax | 9543022420 |
Authorized person
| Name | MR. RAYNY RAMIREZ |
| Role | PRESIDENT |
| Phone | 7863227333 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 116062001 |
| State | FL |
| Issuer | MEDICAID |
| Number | 116062000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| KOSTER CHRISTOPHER A | Manager | 7700 FORSYTH BLVD., ST. LOUIS, MO, 63105 |
| CHERVITZ CHARLES | Manager | 7700 FORSYTH BLVD, ST. LOUIS, MO, 63105 |
| Name | Role | Address |
|---|---|---|
| Dinkelman Tricia | Vice President | 7700 FORSYTH BLVD., ST. LOUIS, MO, 63105 |
| Baiocchi Sarah | Vice President | 7700 FORSYTH BLVD., ST. LOUIS, MO, 63105 |
| Majors Richard A | Vice President | 6100 BLUE LAGOON DRIVE, MIAMI, FL, 33126 |
| Name | Role | Address |
|---|---|---|
| Ramirez Rayny | President | 6100 BLUE LAGOON DRIVE, MIAMI, FL, 33126 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000059906 | COMMUNITY MEDICAL GROUP | ACTIVE | 2022-05-12 | 2027-12-31 | No data | 7700 FORSYTH BLVD., ST. LOUIS, MO, 63105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| AMENDED ANNUAL REPORT | 2023-05-23 |
| ANNUAL REPORT | 2023-05-01 |
| Florida Limited Liability | 2022-04-21 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
