Entity Name: | SYNERGY WELLNESS CENTERS CORP. |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Active |
Date Filed: | 25 Mar 2019 (6 years ago) |
Document Number: | P19000027158 |
FEI/EIN Number | 83-4369185 |
Address: | 17340 N.W 27TH AVE, MIAMI GARDENS, FL, 33056, US |
Mail Address: | 17340 N.W 27TH AVE, MIAMI GARDENS, FL, 33056, US |
ZIP code: | 33056 |
County: | Miami-Dade |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1164057907 | 2020-03-11 | 2023-10-05 | 17340 NW 27TH AVE, MIAMI GARDENS, FL, 330564065, US | 17340 NW 27TH AVE, MIAMI GARDENS, FL, 330564065, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 786-953-6414 |
Phone | +1 786-255-0613 |
Authorized person
Name | ERICKA P CARDOSO |
Role | CEO |
Phone | 7862550613 |
Taxonomy
Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
Is Primary | Yes |
Taxonomy Code | 101YM0800X - Mental Health Counselor |
Is Primary | No |
Taxonomy Code | 251B00000X - Case Management Agency |
Is Primary | No |
Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
Is Primary | No |
Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
Is Primary | No |
Taxonomy Code | 324500000X - Substance Abuse Rehabilitation Facility |
Is Primary | No |
Other Provider Identifiers
Issuer | ACHA |
Number | 12796 |
State | FL |
Issuer | DCF IOP |
Number | 1047931 |
State | FL |
Issuer | DCF OP |
Number | 1047932 |
State | FL |
Issuer | MEDICAID |
Number | 105810500 |
State | FL |
Name | Role | Address |
---|---|---|
CARDOSO ERICKA P | Agent | 17340 N.W 27TH AVE, MIAMI GARDENS, FL, 33056 |
Name | Role | Address |
---|---|---|
CARDOSO ERICKA P | President | 17340 N.W 27TH AVE, MIAMI GARDENS, FL, 33056 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G21000111875 | RENACER CBI | ACTIVE | 2021-08-30 | 2026-12-31 | No data | 3778 W 12 AVENUE, HIALEAH, FL, 33012 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
REGISTERED AGENT ADDRESS CHANGED | 2023-04-29 | 17340 N.W 27TH AVE, MIAMI GARDENS, FL 33056 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2022-09-28 | 17340 N.W 27TH AVE, MIAMI GARDENS, FL 33056 | No data |
CHANGE OF MAILING ADDRESS | 2022-09-28 | 17340 N.W 27TH AVE, MIAMI GARDENS, FL 33056 | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-04-29 |
ANNUAL REPORT | 2023-04-29 |
ANNUAL REPORT | 2022-04-27 |
ANNUAL REPORT | 2021-04-30 |
ANNUAL REPORT | 2020-03-11 |
Domestic Profit | 2019-03-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State