| Entity Name: | REVIVAL MED CENTERS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Jul 2024 (7 months ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 30 Aug 2024 (5 months ago) |
| Document Number: | L24000306904 |
| FEI/EIN Number | 993895411 |
| Address: | 8353 SW 124TH ST, SUITE 207 A, MIAMI, FL, 33156, US |
| Mail Address: | 8353 SW 124TH ST, SUITE 207 A, MIAMI, FL, 33156, US |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871311076 | 2024-09-27 | 2024-09-27 | 8353 SW 124TH ST STE 207A, MIAMI, FL, 331565847, US | 8353 SW 124TH ST STE 207A, MIAMI, FL, 331565847, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 786-443-5833 |
Authorized person
| Name | ROSA ALBA PEREZ |
| Role | OWNER |
| Phone | 5618868459 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEREZ ROSA A | Agent | 8353 SW 124TH ST, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| PEREZ ROSA A | Manager | 2321 SW 58TH AVE, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-08-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-30 | 8353 SW 124TH ST, SUITE 207 A, MIAMI, FL 33156 | No data |
| CHANGE OF MAILING ADDRESS | 2024-08-30 | 8353 SW 124TH ST, SUITE 207 A, MIAMI, FL 33156 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-08-30 | PEREZ, ROSA ALBA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-08-30 | 8353 SW 124TH ST, SUITE 207 A, MIAMI, FL 33156 | No data |
| Name | Date |
|---|---|
| LC Amendment | 2024-08-30 |
| Florida Limited Liability | 2024-07-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
