| Entity Name: | MEDVERSE CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Aug 2024 (6 months ago) |
| Document Number: | L24000379211 |
| Address: | 6850 SW 24TH STREET, 3RD FLOOR, MIAMI, FL 33155 |
| Mail Address: | 6850 SW 24TH STREET, 3RD FLOOR, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619703691 | 2024-09-09 | 2024-10-08 | 6850 SW 24TH ST FL 3, MIAMI, FL, 331551758, US | 6850 CORAL WAY FL 3, MIAMI, FL, 331551758, US | |||||||||||||||||
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| Phone | +1 305-859-0569 |
| Phone | +1 305-265-4441 |
| Fax | 3052654844 |
Authorized person
| Name | KEILA HOOVER |
| Role | OWNER |
| Phone | 3054337419 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SZTYNDOR, ROBYN, ESQ | Agent | 2400 SW 69TH AVE, MIAMI, FL 33155 |
| Name | Role |
|---|---|
| PREMIUM HEALTHCARE MANAGEMENT, LLC | Manager |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-08-29 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
