| Entity Name: | AMBAR HOME HEALTH AGENCY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Nov 2002 (22 years ago) |
| Document Number: | P02000120880 |
| FEI/EIN Number | 141855689 |
| Address: | 633 NE 167 STREET,, NORTH MIAMI BEACH, FL, 33162, US |
| Mail Address: | 633 NE 167 STREET,, NORTH MIAMI BEACH, FL, 33162, US |
| ZIP code: | 33162 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992812515 | 2006-08-23 | 2017-10-12 | 633 NE 167TH ST STE 614, NORTH MIAMI BEACH, FL, 331622444, US | 633 NE 167TH ST STE 614, NORTH MIAMI BEACH, FL, 331622444, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-690-4243 |
| Fax | 3056905883 |
Authorized person
| Name | MS. MARITZA HERNANDEZ |
| Role | OWNER |
| Phone | 3056904243 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991839 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | WELLCARE PROVIDER # |
| Number | 275362 |
| State | FL |
| Issuer | MEDICAID |
| Number | 651049300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ MARITZA | Agent | 789 N.W. 145 TERRACE, MIAMI, FL, 33168 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ MARITZA | President | 633 NE 167 ST, N MIAMI BEACH, FL, 33162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J20000131694 | ACTIVE | 2019-017538-CA-01 | MIAMI-DADE CIRCUIT COURT | 2020-01-31 | 2025-03-02 | $70,368.88 | REGIONS BANK, 1900 FIFTH AVENUE NORTH, BIRMINGHAM, AL 35203 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
