| Entity Name: | BELLE GLADE DIALYSIS CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Dec 2014 (10 years ago) |
| Document Number: | M14000008994 |
| FEI/EIN Number | 47-2491294 |
| Address: | 500 CUMMINGS CENTER, BEVERLY, MA, 01915, US |
| Mail Address: | 933 S.E., 1st Street, Belle Glade, FL, 33430, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225436199 | 2014-12-09 | 2023-01-10 | 933 SE 1ST ST, BELLE GLADE, FL, 334304305, US | 933 SE 1ST ST, BELLE GLADE, FL, 334304305, US | |||||||||||||||||||||
|
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| Phone | +1 561-996-0602 |
| Fax | 5619969610 |
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 | 014649700 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Pandit Sunila M.D. | Member | 500 CUMMINGS CENTER, BEVERLY, MA, 01915 |
| AMERICAN RENAL ASSOCIATES LLC | Member | No data |
| ASHESH, LLC | Member | No data |
| ABRAHAM FAMILY ENTERPRISES, LLC | Member | No data |
| Name | Role | Address |
|---|---|---|
| Kamal Syed T | Manager | 500 CUMMINGS CENTER, BEVERLY, MA, 01915 |
| Abraham Mohan IM.D. | Manager | 500 CUMMINGS CENTER, BEVERLY, MA, 01915 |
| 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 |
| 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 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-02-21 |
| Reg. Agent Change | 2022-05-17 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-17 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-04-11 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
