| Entity Name: | BIG LAKE KIDNEY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 28 Sep 2010 (14 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2022 (3 years ago) |
| Document Number: | M10000004266 |
| FEI/EIN Number |
27-3531328
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 500 Cummings Center, Suite 6550, Beverly, MA, 01915, US |
| Mail Address: | 3420 South Highway 441, Okeechobee, FL, 34974, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821383324 | 2011-06-13 | 2022-08-18 | 3240 HIGHWAY 441 S, OKEECHOBEE, FL, 349746239, US | 3240 HIGHWAY 441 S, OKEECHOBEE, FL, 349746239, US | |||||||||||||||||||||
|
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| Phone | +1 863-824-0225 |
| Fax | 8638240226 |
Authorized person
| Name | KEISHA DENISE GREENE |
| Role | VP OF CLINICAL & REGULATORY |
| Phone | 9785223905 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004431900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | - |
| Flores Maria T | Manager | 1801 S. 23rd Street, Fort Pierce, FL, 34950 |
| Mendez Nick | Manager | 1550 W McEwen Drive, Franklin, TN, 37037 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-02 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | - |
| LC STMNT OF RA/RO CHG | 2022-05-17 | - | - |
| REGISTERED AGENT NAME CHANGED | 2022-05-17 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-17 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-18 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-04-27 |
| CORLCRACHG | 2022-05-17 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-18 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-04-13 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
