| Entity Name: | AMERICAN HEALTH S, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Dec 2022 (2 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 19 Dec 2022 (2 years ago) |
| Document Number: | L22000529622 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 15712 SW 41 STREET, SUITE 11, DAVIE, FL, 33331, US |
| Mail Address: | 15712 SW 41 STREET, SUITE 11, DAVIE, FL, 33331, US |
| ZIP code: | 33331 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053756676 | 2013-05-09 | 2023-04-25 | 15712 SW 41ST ST, SUITE 16-20, DAVIE, FL, 333311538, US | 15712 SW 41ST ST, SUITE 16-20, DAVIE, FL, 333311538, US | |||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 954-919-5005 |
| Fax | 9549195042 |
Authorized person
| Name | MR. CHRIST MARTIN |
| Role | PRESIDENT |
| Phone | 9549195005 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | L8597 |
| State | FL |
| Issuer | STATE LABORATORY LICENSE |
| Number | 8000001801 |
| State | FL |
| Issuer | MEDICAID |
| Number | 064538901 |
| State | FL |
| Issuer | CLIA CERTIFICATE |
| Number | 10D0707800 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role |
|---|---|
| AMERICAN HEALTH HOLDINGS II, LLC | Auth |
| Name | Role | Address |
|---|---|---|
| Martin Christopher | Treasurer | 15712 SW 41 STREET, SUITE 11, DAVIE, FL, 33331 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000010216 | AMERICAN HEALTH ASSOCIATES | ACTIVE | 2023-01-23 | 2028-12-31 | No data | 15712 SW 41ST STREET, STE 11, DAVIE, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2022-12-19 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS S05509. CONVERSION NUMBER 100000234071 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-01-20 |
| Florida Limited Liability | 2022-12-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
