| Entity Name: | ADVANCED THERAPY OF SOUTH FLORIDA LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 May 2022 (3 years ago) |
| Document Number: | L22000240987 |
| FEI/EIN Number | 88-1873432 |
| Address: | 9399 NW 121 TERRACE, HIALEAH GARDENS, FL, 33018 |
| Mail Address: | 9399 NW 121 TERRACE, HIALEAH GARDENS, FL, 33018 |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619662327 | 2023-04-07 | 2024-09-30 | 9399 NW 121ST TER, HIALEAH GARDENS, FL, 330184225, US | 9399 NW 121ST TER, HIALEAH GARDENS, FL, 330184225, US | |||||||||||||||||||||||
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| Phone | +1 786-412-3162 |
Authorized person
| Name | MELISSA SIERRA |
| Role | PRESIDENT |
| Phone | 7864123162 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 120508000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SIERRA MELISSA | Agent | 9399 NW 121 TERRACE, HILAEAH GARDENS, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| SIERRA MELISSA | Authorized Member | 9399 NW 121 TERRACE, HIALEAH GARDENS, FL, 33018 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-03-29 |
| Florida Limited Liability | 2022-05-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
