| Entity Name: | SANTACLARA MED CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 06 May 2024 (9 months ago) |
| Document Number: | L24000211516 |
| FEI/EIN Number | 99-2868262 |
| Address: | 1865 NE 163RD STREET, NORTH MIAMI BEACH, FL 33162 |
| Mail Address: | 8749 WEST 37 AVENUE, APT 303, HIALEAH, FL 33018 |
| ZIP code: | 33162 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215777339 | 2024-05-28 | 2024-05-28 | 8749 WEST 37 AVENUE, APT 303, HIALEAH, FL, 33018, US | 1865 NE 163RD ST, NORTH MIAMI BEACH, FL, 331624805, US | |||||||||||||
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| Phone | +1 786-261-8872 |
Authorized person
| Name | YDANIA SANTACLARA |
| Role | PRESIDENT |
| Phone | 7862618872 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SANTACLARA, YDANIA | Agent | 8749 WEST 37TH AVENUE, APT 303, HIALEAH, FL 33018 |
| Name | Role | Address |
|---|---|---|
| SANTACLARA, YDANIA | Manager | 1865 NE 163RD STREET, NORTH MIAMI BEACH, FL 33162 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-01 |
| Florida Limited Liability | 2024-05-06 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
