| Entity Name: | MIRANDAHEALTH MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Jan 2024 (a year ago) |
| Document Number: | L24000014795 |
| Address: | 255 S ORANGE AVENUE, SUITE 104 # 1211, ORLANDO, FL 32801 |
| Mail Address: | 255 S ORANGE AVENUE, SUITE 104 # 1211, ORLANDO, FL 32801 |
| ZIP code: | 32801 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780447631 | 2024-02-02 | 2024-02-02 | 255 S ORANGE AVE STE 104, ORLANDO, FL, 328013411, US | 1722 WHITE HERON BAY CIRCLE, ORLANDO, FL, 32824, US | |||||||||||||||
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| Phone | +1 209-456-4323 |
| Fax | 8666700132 |
Authorized person
| Name | DR. RAYDEL MIRANDA |
| Role | CEO |
| Phone | 2094564323 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MIRANDA, RAYDEL | Agent | 255 S ORANGE AVENUE, SUITE 104 #1211, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| MIRANDA, RAYDEL | Chief Executive Officer | 255 S ORANGE AVENUE SUITE 104 #1211, ORLANDO, FL 32801 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-05 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
