| Entity Name: | MED-CARE INFUSION SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Jul 1990 (35 years ago) |
| Document Number: | L89149 |
| FEI/EIN Number | 650208178 |
| Mail Address: | 780 NW 42ND AVE, Miami, FL, 33126-5536, US |
| Address: | 3085 WEST 80TH STREET, HIALEAH, FL, 33018, US |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295013563 | 2011-08-03 | 2022-07-13 | 3085 W 80TH ST, HIALEAH, FL, 330183888, US | 8101 W 31ST AVE, HIALEAH, FL, 330183890, US | |||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 305-863-4277 |
| Fax | 3058877761 |
Authorized person
| Name | MR. WILFRED BRACERAS |
| Role | PRES./CEO |
| Phone | 3058638860 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | PH12474 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | 1314317 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102454000 |
| State | FL |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1072242 |
| Name | Role | Address |
|---|---|---|
| BRACERAS WILFRED | Agent | 780 NW 42ND AVE, Miami, FL, 331265536 |
| Name | Role | Address |
|---|---|---|
| BRACERAS WILFRED | President | 780 NW 42ND AVE, Miami, FL, 331265536 |
| Name | Role | Address |
|---|---|---|
| BRACERAS WILFRED | Director | 780 NW 42ND AVE, Miami, FL, 331265536 |
| Name | Role | Address |
|---|---|---|
| BRACERAS WILFRED | Secretary | 780 NW 42ND AVE, Miami, FL, 331265536 |
| Name | Role | Address |
|---|---|---|
| BRACERAS WILFRED | Treasurer | 780 NW 42ND AVE, Miami, FL, 331265536 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000121869 | MEDCARE COMP SOLUTIONS | EXPIRED | 2019-11-13 | 2024-12-31 | No data | 760 PONCE DE LEON BLVD., CORAL GABLES, FL, 33134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 1993-09-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1993-08-13 | No data | No data |
| NAME CHANGE AMENDMENT | 1993-05-24 | MED-CARE INFUSION SERVICES, INC. | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
