| Entity Name: | FIRST CLASS KIDNEY DIALYSIS OF TAMARAC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Jan 2024 (a year ago) |
| Document Number: | L24000015629 |
| Address: | 6803 W. COMMERCIAL BLVD, TAMARC, FL, 33319, US |
| Mail Address: | 250 CONGRESS PARK DR, APT 249, DELRAY BEACH, FL, 33445, US |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811768443 | 2024-01-11 | 2024-01-11 | 250 CONGRESS PARK DR APT 249, DELRAY BEACH, FL, 334454747, US | 6803 W COMMERCIAL BLVD, TAMARAC, FL, 333192116, US | |||||||||||||
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| Phone | +1 561-860-2588 |
Authorized person
| Name | CARLINE CHARLES |
| Role | PRESIDENT |
| Phone | 5618602588 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHARLES CARLINE | Agent | 250 CONGRESS PARK DR, DELRAY BEACH, FL, 33445 |
| Name | Role | Address |
|---|---|---|
| CHARLES CARLINE | Manager | 250 CONGRESS PARK DR, APT 249, DELRAY BEACH, FL, 33445 |
| DIAB AGHA SAMER | Manager | 209 N FORT LAUDERDALE BEACH BLVD, APT 3D, FORT LAUDERDALE, FL, 33304 |
| SCHANKE ANN MARIE | Manager | 90 PRESCOTT E UNIT 90, DEERFIELD BEACH,, FL, 33442 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-05 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
