| Entity Name: | PENATE MEDICAL CENTER 4, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 May 2022 (3 years ago) |
| Document Number: | L22000220961 |
| FEI/EIN Number | 88-2574522 |
| Mail Address: | 8200 SW 117TH AVE STE 112, MIAMI, FL, 33183, US |
| Address: | 4855 NW 183RD, ST MIAMI GARDENS, FL, 33054 |
| ZIP code: | 33054 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447999743 | 2022-06-03 | 2022-06-03 | 8200 SW 117TH AVE STE 112, MIAMI, FL, 331834825, US | 4855 NW 183RD ST, MIAMI GARDENS, FL, 330552955, US | |||||||||||||
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| Phone | +1 786-272-9170 |
Authorized person
| Name | CLARA PENATE |
| Role | AMBR |
| Phone | 7862729170 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLARA IDARME PENATE | Agent | 8200 SW 117TH AVE 112, MIAMI, FL, 33183 |
| Name | Role | Address |
|---|---|---|
| CLARA IDARME PNEATE | Authorized Member | 4855 NW 183RD, MIAMI GARDENS, FL, 33054 |
| LUIS PENATE-PEREZ | Authorized Member | 4855 NW 183RD, MIAMI GARDENS, FL, 33054 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-01-05 |
| Florida Limited Liability | 2022-05-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
