| Entity Name: | LUX MEDICAL HEALTH CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 12 Sep 2016 (8 years ago) |
| Document Number: | P16000075031 |
| FEI/EIN Number | 81-3846937 |
| Address: | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 |
| Mail Address: | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 |
| ZIP code: | 33020 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467995894 | 2016-12-03 | 2021-08-03 | 1200 S FEDERAL HWY, HOLLYWOOD, FL, 330206030, US | 1200 S FEDERAL HWY, HOLLYWOOD, FL, 330206030, US | |||||||||||||||||||||||||
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| Phone | +1 786-715-1059 |
| Fax | 9544438496 |
Authorized person
| Name | DR. LUIS MANUEL GONZALEZ |
| Role | PRESIDENT |
| Phone | 7867151059 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 023990400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, LUIS M | Agent | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, LUIS M | President | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 |
| Name | Role | Address |
|---|---|---|
| TASCHERET, ANA | Vice President | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-06-19 | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 | No data |
| CHANGE OF MAILING ADDRESS | 2017-06-19 | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-06-19 | 1200 SOUTH FEDERAL HWY, HOLLYWOOD, FL 33020 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-07-29 |
| ANNUAL REPORT | 2019-03-28 |
| ANNUAL REPORT | 2018-02-19 |
| AMENDED ANNUAL REPORT | 2017-12-08 |
| AMENDED ANNUAL REPORT | 2017-06-19 |
| ANNUAL REPORT | 2017-04-17 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
