| Entity Name: | MIAMI RESCUE MISSION CLINIC INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Apr 2011 (14 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 01 Nov 2012 (12 years ago) |
| Document Number: | N11000003523 |
| FEI/EIN Number | 45-1481860 |
| Address: | 2015 NW 1ST AVENUE, MIAMI, FL 33127 |
| Mail Address: | 2015 NW 1ST AVENUE, MIAMI, FL 33127 |
| ZIP code: | 33127 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396276846 | 2017-03-27 | 2017-03-27 | 2015 NW 1ST AVE, MIAMI, FL, 331274901, US | 2015 NW 1ST AVE, MIAMI, FL, 331274901, US | |||||||||||||||||||||||
|
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| Phone | +1 305-572-2026 |
Authorized person
| Name | DR. PETE GUTIERREZ |
| Role | MEDICAL DIRECTOR |
| Phone | 3055722026 |
Taxonomy
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| License Number | ACN296 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003537402 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gutierrez, Pete A | Agent | 2015 NW 1st avenue, MIAMI, FL 33127 |
| Name | Role | Address |
|---|---|---|
| GUTIERREZ, PETE | President | 2015 NW 1ST AVENUE, MIAMI, FL 33127 |
| Name | Role | Address |
|---|---|---|
| BRUMMITT, RONALD | Vice President | 2015 NW 1ST AVENUE, MIAMI, FL 33127 |
| Name | Role | Address |
|---|---|---|
| Bretones-Graham, Gisela | Chief Operating Officer | 2015 NW 1ST AVENUE, MIAMI, FL 33127 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000122404 | CARING PLACE CLINIC | ACTIVE | 2019-11-14 | 2029-12-31 | No data | 2015 NW 1ST AVENUE, MIAMI, FL, 33127 |
| G15000023341 | MIAMI RESCUE MISSION HEALTH CLINIC | ACTIVE | 2015-03-04 | 2025-12-31 | No data | 2015 NW 1 AVENUE, MIAMI, FL, 33127 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2013-04-10 | Gutierrez, Pete A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-10 | 2015 NW 1st avenue, MIAMI, FL 33127 | No data |
| AMENDMENT | 2012-11-01 | No data | No data |
| AMENDMENT | 2011-10-11 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-05 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-03-02 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-01-14 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
