| Entity Name: | NURSE MENTORS HEALTHCARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Nov 2022 (2 years ago) |
| Document Number: | L22000480020 |
| FEI/EIN Number | 92-1002803 |
| Address: | 6151 MIRAMAR PARKWAY, SUITE 306, MIRAMAR, FL, 33023 |
| Mail Address: | 6151 MIRAMAR PARKWAY, SUITE 306, MIRAMAR, FL, 33023 |
| ZIP code: | 33023 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447824461 | 2021-05-14 | 2022-11-10 | 6151 MIRAMAR PKWY STE 306, MIRAMAR, FL, 330233985, US | 6151 MIRAMAR PKWY, MIRAMAR, FL, 330233970, US | |||||||||||||||||||||||||||||||
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| Phone | +1 954-559-0166 |
| Fax | 9542720166 |
| Fax | 9542728437 |
Authorized person
| Name | GERDA M WILLIAMS |
| Role | ADMINISTRATOR |
| Phone | 9549666467 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LC1500X - Community Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 301511400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS GERDA M | Agent | 6151 MIRAMAR PARKWAY, MIRAMAR, FL, 33023 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS GERDA M | Manager | 6151 MIRAMAR PARKWAY, SUITE 306, MIRAMAR, FL, 33023 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS DANIEL C | Authorized Member | 6151 MIRAMAR PARKWAY, SUITE 306, MIRAMAR, FL, 33023 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-04-22 |
| Florida Limited Liability | 2022-11-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
