| Entity Name: | MOONSHINE ALF LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Sep 2022 (2 years ago) |
| Document Number: | L22000397596 |
| FEI/EIN Number | 88-4347984 |
| Address: | 19240 SW 124 CT, MIAMI, FL 33177 |
| Mail Address: | 1100 SW 93 AVE, MIAMI, FL 33174 |
| ZIP code: | 33177 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386349710 | 2023-04-04 | 2023-04-04 | 19240 SW 124TH CT, MIAMI, FL, 331776500, US | 19240 SW 124TH CT, MIAMI, FL, 331776500, US | |||||||||||||||||||||
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| Phone | +1 305-278-7314 |
| Fax | 7862445787 |
Authorized person
| Name | ARMANDO FANDINO ESPINOSA |
| Role | OWNER |
| Phone | 7866916809 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA |
| Number | 9350 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FANDINO ESPINOSA, ARMANDO | Agent | 19240 SW 124 CT, MIAMI, FL 33177 |
| Name | Role | Address |
|---|---|---|
| FANDINO ESPINOSA, ARMANDO | Authorized Member | 19240 SW 124 CT, MIAMI, FL 33177 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-03-06 | 19240 SW 124 CT, MIAMI, FL 33177 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-03-20 |
| Florida Limited Liability | 2022-09-12 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
