| Entity Name: | MAXICARE SELECT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Feb 2000 (25 years ago) |
| Document Number: | P00000020241 |
| FEI/EIN Number | 650986933 |
| Address: | 4300 N University Dr, Lauderhill, FL, 33351, US |
| Mail Address: | 4300 N University Dr, Lauderhill, FL, 33351, US |
| ZIP code: | 33351 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467678813 | 2007-04-17 | 2015-08-27 | 8333 W. MCNAB RD. #113, TAMARAC, FL, 33321, US | 8333 W. MCNAB RD #113, TAMARAC, FL, 33321, US | |||||||||||||||||||||||||||
|
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| Phone | +1 954-771-2399 |
| Fax | 9547712491 |
Authorized person
| Name | LISA COOPER |
| Role | PRESIDENT |
| Phone | 9547712399 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991555 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991469 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Cooper Lisa | Agent | 4300 N University Dr, Lauderhill, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| Cooper Lisa | Secretary | 4300 N University Dr, Lauderhill, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| Baumann Brent | Treasurer | 4300 N University Dr, Lauderhill, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| Beavers Shad | Vice President | 4300 N University Dr, Lauderhill, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| McDonald Brian | President | 4300 N University Dr, Lauderhill, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| Legacy Care Partners, LLC | Othe | 4300 N University Dr, Lauderhill, FL, 33351 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000035868 | MULTI-MED HEALTHCARE | EXPIRED | 2015-04-09 | 2020-12-31 | No data | 934 NORTH UNIVERSITY DRIVE, SUITE 219, CORAL SPRINGS, FL, 33071 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-06-26 | 4300 N University Dr, STE D106, Lauderhill, FL 33351 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-09-06 | 4300 N University Dr, STE D106, Lauderhill, FL 33351 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-06 | 4300 N University Dr, STE D106, Lauderhill, FL 33351 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-17 | Cooper, Lisa | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-06-26 |
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-01-11 |
| AMENDED ANNUAL REPORT | 2022-08-25 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-02-17 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
