Entity Name: | HEALTH KTP LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Company |
Status: | Active |
Date Filed: | 18 Mar 2024 (a year ago) |
Document Number: | L24000131579 |
Address: | 14719 SW 9TH TERR, MIAMI, FL 33194 |
Mail Address: | 14719 SW 9TH TERR, MIAMI, FL 33194 |
ZIP code: | 33194 |
County: | Miami-Dade |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1942023676 | 2024-11-01 | 2024-11-01 | 12955 BISCAYNE BLVD STE 200, NORTH MIAMI, FL, 331812021, US | 12955 BISCAYNE BLVD STE 200, NORTH MIAMI, FL, 331812021, US | |||||||||||||||||||||
|
Phone | +1 786-245-3035 |
Authorized person
Name | KIRA TEJADA |
Role | NURSE PRACTITIONER |
Phone | 7862453035 |
Taxonomy
Taxonomy Code | 363L00000X - Nurse Practitioner |
Is Primary | Yes |
Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
Is Primary | No |
Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
Is Primary | No |
Name | Role | Address |
---|---|---|
BAEZ, WILMARK | Agent | 13497 NW 47TH AVE, OPA LOCKA, FL 33054 |
Name | Role | Address |
---|---|---|
TEJADA PEREZ, KIRA | Manager | 14719 SW 9TH TERR, MIAMI, FL 33194 |
Name | Date |
---|---|
Florida Limited Liability | 2024-03-18 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State