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ILAVANDERA APRN, LLC - Florida Company Profile

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Company Details

Entity Name: ILAVANDERA APRN, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 13 Jul 2022 (3 years ago)
Document Number: L22000311490
FEI/EIN Number 88-3296853
Address: 11654 SW 142 PLACE, MIAMI, FL, 33186
Mail Address: 11654 SW 142 PLACE, MIAMI, FL, 33186, UN
ZIP code: 33186
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
LAVANDERA RODRIGUEZ IVAN Manager 11654 SW 142 PLACE, MIAMI, FL, 33186
PEREZ RODRIGUEZ ILEANA Agent 11654 SW 142 PLACE, MIAMI, FL, 33186

National Provider Identifier

NPI Number:
1164133039
Certification Date:
2022-12-12

Authorized Person:

Name:
MR. IVAN LAVANDERA RODRIGUEZ
Role:
AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Documents

Name Date
ANNUAL REPORT 2024-03-06
ANNUAL REPORT 2023-04-01
Florida Limited Liability 2022-07-13

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Date of last update: 01 Jul 2025

Sources: Florida Department of State