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DIAMOND WELLNESS & MED CENTER LLC - Florida Company Profile

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Company Details

Entity Name: DIAMOND WELLNESS & MED CENTER LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 22 Jul 2024 (a year ago)
Document Number: L24000324017
FEI/EIN Number 994282246
Address: 1470 NW 107TH AVENUE, M, MIAMI, FL, 33172, US
Mail Address: 1470 NW 107TH AVENUE, M, MIAMI, FL, 33172, US
ZIP code: 33172
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PINEDA YASMIN L Manager 1470 NW 107 AVENUE M, MIAMI, FL, 33172
PEREZ PENA MONICA Manager 1470 NW 107 AVENUE M, MIAMI, FL, 33172
PINEDA YASMIN L Agent 1470 NW 107 AVENUE, MIAMI, FL, 33172

National Provider Identifier

NPI Number:
1124839618
Certification Date:
2025-01-15

Authorized Person:

Name:
MONICA PATRICIA PEREZ -PENA
Role:
MGR
Phone:

Taxonomy:

Selected Taxonomy:
207QS0010X - Sports Medicine (Family Medicine) Physician
Is Primary:
No
Selected Taxonomy:
261QI0500X - Infusion Therapy Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP1100X - Podiatric Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QR0400X - Rehabilitation Clinic/Center
Is Primary:
No

Contacts:

Documents

Name Date
Florida Limited Liability 2024-07-22

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Date of last update: 03 Aug 2025

Sources: Florida Department of State