| Entity Name: | ESTERLYN'S HOUSE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 04 Jan 2016 (9 years ago) |
| Document Number: | N16000000043 |
| FEI/EIN Number | 81-0993402 |
| Address: | 1200 BRICKELL AVENUE,, SUITE 1950, MIAMI, FL, 33131, US |
| Mail Address: | 1200 BRICKELL AVENUE,, SUITE 1950, MIAMI, FL, 33131, US |
| ZIP code: | 33131 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366076093 | 2020-03-03 | 2020-03-03 | 1200 BRICKELL AVE STE 1950, MIAMI, FL, 331313298, US | 1200 BRICKELL AVE STE 1950, MIAMI, FL, 331313298, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 504-756-1795 |
Authorized person
| Name | DR. EMRON O WALWYN SR. |
| Role | MEDICAL DIRECTOR |
| Phone | 5047561795 |
Taxonomy
| Taxonomy Code | 104100000X - Social Worker |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | No |
| Taxonomy Code | 347C00000X - Private Vehicle |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1346535820 |
| State | FL |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Walwyn Emron | President | 1200 BRICKELL AVENUE Suite 1950, MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| Lawrence Edward | Secretary | 1200 BRICKELL AVENUE, MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| Sadiq Rahman | Treasurer | 1200 BRICKELL AVENUE,, MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| Walwyn Esterlyn | Director | 1200 BRICKELL AVENUE,, MIAMI, FL, 33131 |
| Walwyn Ezmon | Director | 1200 BRICKELL AVENUE,, MIAMI, FL, 33131 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-11 | 1200 BRICKELL AVENUE,, SUITE 1950, Office Space #23, MIAMI, FL 33131 | No data |
| CHANGE OF MAILING ADDRESS | 2024-09-11 | 1200 BRICKELL AVENUE,, SUITE 1950, Office Space #23, MIAMI, FL 33131 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-18 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-09-11 |
| ANNUAL REPORT | 2024-01-20 |
| ANNUAL REPORT | 2023-08-24 |
| ANNUAL REPORT | 2022-07-15 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-05-05 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-06-07 |
| ANNUAL REPORT | 2017-05-01 |
| Domestic Non-Profit | 2016-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
