| Entity Name: | SEPA CENTRAL FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 24 Jun 2019 (6 years ago) |
| Document Number: | P19000053073 |
| FEI/EIN Number | 84-2187872 |
| Address: | 10621 NORTH KENDALL DR, SUITE 211, MIAMI, FL 33176 |
| Mail Address: | 10621 NORTH KENDALL DR, SUITE 211, MIAMI, FL 33176 |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619646635 | 2021-09-13 | 2021-09-13 | 10621 N KENDALL DR STE 211, MIAMI, FL, 331761530, US | 10621 N KENDALL DR STE 211, MIAMI, FL, 331761530, US | |||||||||||||
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| Phone | +1 305-596-4288 |
Authorized person
| Name | RENE F GOMEZ |
| Role | CEO |
| Phone | 3055964288 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Name | Role |
|---|---|
| AXEN HEALTH, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| De Jesus, Ivan D. | Chief Executive Officer | 2103 Coral Way, 2nd Floor Coral Gables, FL 33145 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-30 | AXEN Health, Inc. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-30 | 2103 Coral Way, 2nd Floor, Coral Gables, FL 33145 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| AMENDED ANNUAL REPORT | 2023-08-29 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-04 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-03-13 |
| Domestic Profit | 2019-06-24 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
