| Entity Name: | HERITAGE HOMECARE OF BROWARD, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 May 2000 (25 years ago) |
| Document Number: | P00000051970 |
| FEI/EIN Number | 651011552 |
| Address: | 7900 NOVA DRIVE, SUITE 201, DAVIE, FL, 33324 |
| Mail Address: | 7900 NOVA DRIVE, SUITE 201, DAVIE, FL, 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972553188 | 2006-05-10 | 2010-06-25 | 7900 NOVA DR, SUITE 201, DAVIE, FL, 333245821, US | 7900 NOVA DR, SUITE 201, DAVIE, FL, 333245821, US | |||||||||||||||||||||||||
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| Phone | +1 954-452-8100 |
| Fax | 9544246219 |
Authorized person
| Name | STEVEN RODRIGUEZ |
| Role | CFO |
| Phone | 9544528100 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | HHA299991474 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 650887100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ DAVID A | Agent | 7900 NOVA DRIVE, DAVIE, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| KEMPER KIMBERLY A | Director | 7900 NOVA DRIVE, SUITE 201, DAVIE, FL, 33324 |
| RODRIGUEZ DAVID A | Director | 7900 NOVA DRIVE, SUITE 201, DAVIE, FL, 33324 |
| RODRIGUEZ STEVEN S | Director | 7900 NOVA DRIVE, SUITE 201, DAVIE, FL, 33324 |
| CONNIE RODRIGUEZ TRUST | Director | 7900 NOVA DRIVE SUITE 201, DAVIE, FL, 33324 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G00158900042 | HERITAGE HOMECARE | ACTIVE | 2000-06-09 | 2025-12-31 | No data | 7900 NOVA DR, STE 201, DAVIE, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2014-04-16 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
