| Entity Name: | EXCELLENCE MEDICAL GROUP, CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 28 Jan 2011 (14 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 27 Dec 2013 (11 years ago) |
| Document Number: | P11000010058 |
| FEI/EIN Number | 27-4738378 |
| Address: | 7959 NW 2 ST, MIAMI, FL 33126 |
| Mail Address: | 7959 NW 2 ST, MIAMI, FL 33126 |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497049423 | 2011-06-07 | 2022-09-08 | 7959 NW 2ND ST, MIAMI, FL, 331268000, US | 7959 NW 2ND ST, MIAMI, FL, 331268000, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-267-6060 |
| Fax | 3052676055 |
Authorized person
| Name | BARBARA SUAREZ |
| Role | OWNER |
| Phone | 3052676060 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC9122 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | AHCA HCC UNIT |
| Number | FILE 9666 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SUAREZ, BARBARA | Agent | 7959 NW 2ND ST, MIAMI, FL 33126 |
| Name | Role | Address |
|---|---|---|
| SUAREZ, BARBARA | President | 7959 NW 2 ST, MIAMI, FL 33126 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-05-01 | SUAREZ, BARBARA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-01 | 7959 NW 2ND ST, MIAMI, FL 33126 | No data |
| AMENDMENT | 2013-12-27 | No data | No data |
| AMENDMENT | 2013-07-12 | No data | No data |
| AMENDMENT | 2011-02-04 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-05-01 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-02-27 |
| ANNUAL REPORT | 2016-03-09 |
| AMENDED ANNUAL REPORT | 2015-09-21 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
