| Entity Name: | CELEN MEDICAL GROUP, CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Nov 2016 (8 years ago) |
| Document Number: | P16000089162 |
| FEI/EIN Number | 81-4367922 |
| Address: | 7930 NW 36th Street, DORAL, FL, 33166, US |
| Mail Address: | 7930 NW 36th Street, DORAL, FL, 33166, US |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558803056 | 2016-11-15 | 2022-06-26 | 7930 NW 36TH ST STE 215, DORAL, FL, 331666677, US | 7930 NW 36TH ST STE 215, DORAL, FL, 331666677, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 305-677-9110 |
| Fax | 8773475666 |
| Fax | 3056779111 |
Authorized person
| Name | NOSLEN SANCHEZ MESA |
| Role | PRESIDENT/CEO |
| Phone | 3055872418 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QR1100X - Research Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020648800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 104412200 |
| State | FL |
| Issuer | AHCA |
| Number | HCC12379 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANCHEZ MESA NOSLEN | Agent | 7930 NW 36th Street, DORAL, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| SANCHEZ MESA NOSLEN | Chief Executive Officer | 7930 NW 36th Street, DORAL, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| Padron Celia | Chief Operating Officer | 7930 NW 36th Street, Doral, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-04 | 7930 NW 36th Street, SUITE 215, DORAL, FL 33166 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-04 | SANCHEZ MESA, NOSLEN | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-05 | 7930 NW 36th Street, SUITE 215, DORAL, FL 33166 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-05 | 7930 NW 36th Street, SUITE 215, DORAL, FL 33166 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-15 |
| AMENDED ANNUAL REPORT | 2022-05-25 |
| ANNUAL REPORT | 2022-04-05 |
| AMENDED ANNUAL REPORT | 2021-10-20 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-03-27 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
