| Entity Name: | FORT LAUDERDALE RENAL DIALYSIS, 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: | 21 Feb 2012 (13 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2022 (3 years ago) |
| Document Number: | M12000000969 |
| FEI/EIN Number |
45-4582817
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 500 Cummings Center, Beverly, MA, 01915, US |
| Mail Address: | 6264-71 North Federal Highway, Space, Suite 140-144, Fort Lauderdale,, FL, 33308, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801160809 | 2012-03-08 | 2020-03-16 | 6264 N FEDERAL HWY, FORT LAUDERDALE, FL, 333081904, US | 6264 N FEDERAL HWY, FORT LAUDERDALE, FL, 333081904, US | |||||||||||||||||||||
|
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| Phone | +1 954-776-3791 |
| Fax | 9547717527 |
Authorized person
| Name | SHARI K COUSINS |
| Role | SR. VP OF CLINICAL & REGULATORY |
| Phone | 9789223080 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005936600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Quintero J. FM.D. | Member | 500 Cummings Center, Beverly, MA, 01915 |
| Coquis Robert PM.D. | Member | 500 Cummings Center, Beverly, MA, 01915 |
| Kamal Syed T | Manager | 500 Cummings Center, Beverly, MA, 01915 |
| Mendez Nick | Manager | 1550 W. MCEWEN DE., FRANKLIN, TN, 37067 |
| AMERICAN RENAL ASSOCIATES LLC | Member | - |
| CORPORATION SERVICE COMPANY | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-21 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | - |
| CHANGE OF MAILING ADDRESS | 2023-02-21 | 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 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-24 |
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-02-21 |
| CORLCRACHG | 2022-05-17 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-17 |
| ANNUAL REPORT | 2020-06-04 |
| ANNUAL REPORT | 2019-03-20 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-17 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
