Entity Name: | FLORIDA DIALYSIS CENTER OF CELEBRATION, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Foreign Limited Liability Co. |
Status: | Active |
Date Filed: | 18 Jun 2014 (11 years ago) |
Last Event: | LC STMNT OF RA/RO CHG |
Event Date Filed: | 17 May 2022 (3 years ago) |
Document Number: | M14000004309 |
FEI/EIN Number | 47-1064933 |
Address: | 500 Cummings Center, Beverly, MA, 01915, US |
Mail Address: | Midway Plaza, 5051 W Irlo Bronson Memorial Highway, Kissimmee, FL, 34746, US |
Place of Formation: | DELAWARE |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1609273887 | 2014-12-03 | 2023-01-10 | 5051 W IRLO BRONSON MEMORIAL HWY, KISSIMMEE, FL, 347465345, US | 5051 W IRLO BRONSON MEMORIAL HWY, KISSIMMEE, FL, 347465345, US | |||||||||||||||||||||
|
Phone | +1 407-397-2588 |
Fax | 4073972589 |
Authorized person
Name | SARA ANNE BRADY |
Role | CHIEF NURSING OFFICER |
Phone | 2083717878 |
Taxonomy
Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 015358600 |
State | FL |
Name | Role |
---|---|
CORPORATION SERVICE COMPANY | Agent |
Name | Role | Address |
---|---|---|
Kamal Syed T | Manager | 500 Cummings Center, Beverly, MA, 01915 |
Navani Anil | Manager | 500 Cummings Center, Beverly, MA, 01915 |
Mendez Nick | Manager | 1550 W. MCEWEN DR, FRANKLIN, TN, 37067 |
El Toukhy Amr MD | Manager | 500 Cummings Center, Beverly, MA, 01915 |
Name | Role |
---|---|
AMERICAN RENAL ASSOCIATES LLC | Member |
HD INVESTMENTS LLC | Member |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF MAILING ADDRESS | 2024-02-23 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2023-02-21 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | No data |
LC STMNT OF RA/RO CHG | 2022-05-17 | No data | No data |
REGISTERED AGENT NAME CHANGED | 2022-05-17 | CORPORATION SERVICE COMPANY | No data |
REGISTERED AGENT ADDRESS CHANGED | 2022-05-17 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | No data |
Name | Date |
---|---|
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 | 2018-04-11 |
ANNUAL REPORT | 2017-04-17 |
ANNUAL REPORT | 2016-04-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State