| Entity Name: | ICOM HIALEAH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Dec 2022 (2 years ago) |
| Document Number: | L22000532880 |
| FEI/EIN Number | 88-4420787 |
| Mail Address: | 5201 NE 33rd AVE, FORT LAUDERDALE, FL, 33308, US |
| Address: | 6600 W 12th AVE, HIALEAH, FL, 33012, US |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376313130 | 2024-01-03 | 2024-01-03 | 611 NE 13TH ST, FT LAUDERDALE, FL, 333041109, US | 6600 W 12TH AVE, HIALEAH, FL, 330126450, US | |||||||||||||||
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| Phone | +1 305-846-7987 |
| Fax | 7862214442 |
Authorized person
| Name | TATIANA SANTIAGO HERZOG |
| Role | DENTIST |
| Phone | 3054095392 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HERZOG TATIANA S | Agent | 5201 NE 33rd AVE, FORT LAUDERDALE, FL, 33308 |
| Name | Role | Address |
|---|---|---|
| HERZOG TATIANA | Manager | 5201 NE 33rd AVE, FORT LAUDERDALE, FL, 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-24 | 6600 W 12th AVE, HIALEAH, FL 33012 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-24 | 5201 NE 33rd AVE, FORT LAUDERDALE, FL 33308 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-02 | 6600 W 12th AVE, HIALEAH, FL 33012 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-03-02 |
| Florida Limited Liability | 2022-12-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
