| Entity Name: | CORVA CLINICS - MIAMI SHORES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 24 Oct 2012 (13 years ago) |
| Date of dissolution: | 25 Sep 2015 (10 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (10 years ago) |
| Document Number: | M12000005997 |
| FEI/EIN Number |
352452736
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 5613 DTC PARKWAY, STE. 800, GREENWOOD VILLAGE, CO, 80111 |
| Mail Address: | 5613 DTC PARKWAY, STE. 800, GREENWOOD VILLAGE, CO, 80111 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033467816 | 2012-08-27 | 2012-08-27 | 5613 DTC PKWY, SUITE 800, GREENWOOD VILLAGE, CO, 801113028, US | 9999 NE 2ND AVE, MIAMI SHORES, FL, 331382352, US | |||||||||||||||||||||
|
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| Phone | +1 720-402-3881 |
| Phone | +1 305-756-4400 |
Authorized person
| Name | JERRY SIMONSEN |
| Role | CEO |
| Phone | 7204023881 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PROVIDER NUMBER |
| Number | 102800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | - |
| SIMONSEN JERRY | Manager | 5613 DTC PARKWAY, STE. 800, GREENWOOD VILLAGE, CO, 80111 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000104865 | CORVA KIDNEY CENTER - MIAMI SHORES | EXPIRED | 2012-10-29 | 2017-12-31 | - | 5613 DTC PARKWAY, STE. 800, GREENWOOD VILLAGE, CO, 80111 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2015-09-25 | - | - |
| REINSTATEMENT | 2013-10-16 | - | - |
| REVOKED FOR ANNUAL REPORT | 2013-09-27 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-18 |
| REINSTATEMENT | 2013-10-16 |
| Foreign Limited | 2012-10-24 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
