| Entity Name: | SOUTHEASTERN COMMUNITY MENTAL HEALTH CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Dec 2004 (20 years ago) |
| Date of dissolution: | 09 Jul 2013 (12 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 09 Jul 2013 (12 years ago) |
| Document Number: | P04000170736 |
| FEI/EIN Number | 352244441 |
| Address: | 13550 SW 88 STREET, SUITE 130, MIAMI, FL, 33186 |
| Mail Address: | 13550 SW 88 STREET, SUITE 130, MIAMI, FL, 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154347706 | 2006-07-15 | 2010-09-21 | 13550 SW 88TH ST STE 130, MIAMI, FL, 331861540, US | 13550 SW 88TH ST STE 130, MIAMI, FL, 331861540, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-383-6565 |
| Fax | 3053837767 |
Authorized person
| Name | MARIA E CAMEJO |
| Role | PRESIDENT |
| Phone | 3053836565 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002011400 |
| State | FL |
| Issuer | AETNA |
| Number | 9792421 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZIRKLE MARIA ELENA | Agent | 13550 SW 88 STREET, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| ZIRKLE MARIA ELENA | President | 13550 SW 88 STREET #130, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| ZIRKLE MARIA ELENA | Secretary | 13550 SW 88 STREET #130, MIAMI, FL, 33186 |
| PUIG ELENA | Secretary | 13550 SW 88 STREET #130, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| PUIG ELENA | Director | 13550 SW 88 STREET #130, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-07-09 | No data | No data |
| REINSTATEMENT | 2012-12-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-12-12 | 13550 SW 88 STREET, SUITE 130, MIAMI, FL 33175 | No data |
| REINSTATEMENT | 2011-12-12 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-12-12 | 13550 SW 88 STREET, SUITE 130, MIAMI, FL 33186 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| AMENDMENT | 2011-04-29 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-04-29 | ZIRKLE, MARIA ELENA | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-08 | 13550 SW 88 STREET, SUITE 130, MIAMI, FL 33186 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-07-09 |
| REINSTATEMENT | 2012-12-04 |
| REINSTATEMENT | 2011-12-12 |
| Amendment | 2011-04-29 |
| Off/Dir Resignation | 2010-03-01 |
| ANNUAL REPORT | 2010-01-18 |
| ANNUAL REPORT | 2009-04-20 |
| ANNUAL REPORT | 2008-01-08 |
| ANNUAL REPORT | 2007-02-19 |
| ANNUAL REPORT | 2006-03-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
