| Entity Name: | SANDRA SANCHEZ LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Oct 2023 (a year ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 12 Sep 2024 (5 months ago) |
| Document Number: | L23000491728 |
| FEI/EIN Number | 93-4214064 |
| Address: | 187 YALE DR, LAKE WORTH BEACH, FL 33460 |
| Mail Address: | 187 YALE DR, LAKE WORTH BEACH, FL 33460 |
| ZIP code: | 33460 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386400505 | 2024-02-26 | 2024-08-19 | 187 YALE DR, LAKE WORTH BEACH, FL, 334606360, US | 187 YALE DR, LAKE WORTH BEACH, FL, 334606360, US | |||||||||||||||||||||||
|
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| Phone | +1 561-702-0042 |
Authorized person
| Name | LAURA M CASTILLO |
| Role | OWNER |
| Phone | 5617010042 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 182175564 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CASTILLO, LAURA M | Agent | 187 YALE DR, LAKE WORTH BEACH, FL 33460 |
| Name | Role | Address |
|---|---|---|
| SANCHEZ, SANDRA | NP | 6735 OLD FARM TRAIL, BOYTON BEACH, FL 33437 |
| Name | Role | Address |
|---|---|---|
| CASTILLO, LAURA | Manager | 187 YALE DR, LAKE WORTH BEACH, FL 33460 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000118238 | TU SALUD SIEMPRE PRIMERO | ACTIVE | 2024-09-20 | 2029-12-31 | No data | 187 YALE DR, LAKE WORTH BEACH, FL, 33460 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2024-09-12 | SANDRA SANCHEZ LLC | No data |
| Name | Date |
|---|---|
| LC Name Change | 2024-09-12 |
| ANNUAL REPORT | 2024-04-30 |
| Florida Limited Liability | 2023-10-27 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
