| Entity Name: | MALIBU LOVE & CARE HEALTHCARE AGENCY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Mar 2006 (19 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 19 Aug 2024 (6 months ago) |
| Document Number: | P06000043787 |
| FEI/EIN Number | 161750312 |
| Address: | 1781 NW 123rd Ave, PEMBROKE PINES, FL, 33026, US |
| Mail Address: | 1781 NW 123rd Ave, PEMBROKE PINES, FL, 33026, US |
| ZIP code: | 33026 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114124955 | 2007-06-27 | 2020-07-11 | 1468 S PALM AVE, PEMBROKE PINES, FL, 330255520, US | 1468 S PALM AVE, PEMBROKE PINES, FL, 330255520, US | |||||||||||||||||||||||||
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| Phone | +1 954-362-3831 |
| Fax | 9543623832 |
Authorized person
| Name | MRS. ROSEMARIE NICHOLAS |
| Role | VICE PRESIDENT |
| Phone | 9543623831 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299992636 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101778500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PARRAM GINO RAY | Agent | 1781 NW 123rd Ave, PEMBROKE PINES, FL, 33026 |
| Name | Role | Address |
|---|---|---|
| PARRAM GINO RAY | President | 1468 SOUTH PALM AVENUE, PEMBROKE PINES, FL, 33025 |
| Name | Role | Address |
|---|---|---|
| PARRAM GINO RAY | Director | 1468 SOUTH PALM AVENUE, PEMBROKE PINES, FL, 33025 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08303900041 | MALIBU LOVE AND CARE, INC. | EXPIRED | 2008-10-28 | 2013-12-31 | No data | 6517 TAFT STREET, SUITE 220, HOLLYWOOD, FL, 33024 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2024-08-19 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-16 | 1781 NW 123rd Ave, PEMBROKE PINES, FL 33026 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-16 | 1781 NW 123rd Ave, PEMBROKE PINES, FL 33026 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-16 | 1781 NW 123rd Ave, PEMBROKE PINES, FL 33026 | No data |
| AMENDMENT | 2021-07-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-07-01 | PARRAM, GINO RAY | No data |
| NAME CHANGE AMENDMENT | 2020-10-13 | MALIBU LOVE & CARE HEALTHCARE AGENCY, INC. | No data |
| AMENDMENT | 2018-10-04 | No data | No data |
| AMENDMENT | 2018-08-15 | No data | No data |
| REINSTATEMENT | 2011-09-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000556334 | TERMINATED | 1000000938336 | BROWARD | 2022-12-07 | 2032-12-14 | $ 733.92 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J13001653675 | TERMINATED | 1000000547511 | BROWARD | 2013-10-16 | 2023-11-07 | $ 1,344.81 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J13000056193 | TERMINATED | 1000000446620 | BROWARD | 2012-12-26 | 2023-01-02 | $ 1,642.25 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J11000489315 | LAPSED | 1000000226606 | BROWARD | 2011-07-20 | 2021-08-03 | $ 1,462.66 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096 |
| Name | Date |
|---|---|
| Amendment | 2024-08-19 |
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-08-18 |
| Amendment | 2021-07-01 |
| Name Change | 2020-10-13 |
| AMENDED ANNUAL REPORT | 2020-08-13 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
