| Entity Name: | PRIME CARE HME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Sep 2020 (4 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 31 Oct 2022 (2 years ago) |
| Document Number: | P20000077324 |
| FEI/EIN Number | 85-3345023 |
| Address: | 7438 SW 48 Street, A, Miami, FL, 33155, US |
| Mail Address: | 7438 SW 48 Street, A, Miami, FL, 33155, US |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508537242 | 2021-09-22 | 2023-04-25 | 4708 SW 74TH AVE, MIAMI, FL, 331554417, US | 4708 SW 74TH AVE, MIAMI, FL, 331554417, US | |||||||||||||||||||||||||||
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| Phone | +1 786-478-6178 |
| Fax | 3059647065 |
Authorized person
| Name | MRS. YVONNE SUSAN SOTTO |
| Role | VICE PRESIDENT |
| Phone | 7864786178 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF FLORIDA |
| Number | M7NG5 |
| State | FL |
| Issuer | MEDICAID |
| Number | 114228800 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PRIME CARE HME 401(K) PLAN | 2023 | 853345023 | 2024-05-28 | PRIME CARE HME | 3 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-28 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SOTTO YVONNE S | Agent | 7438 SW 48 Street, Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| SILVEIRA EDUARDO A | President | 7438 SW 48 Street, Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| SOTTO YVONNE S | Vice President | 7438 SW 48 Street, Miami, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-21 | 7438 SW 48 Street, A, Miami, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-21 | 7438 SW 48 Street, A, Miami, FL 33155 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-10-21 | 7438 SW 48 Street, A, Miami, FL 33155 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-12 | SOTTO, YVONNE SUSAN | No data |
| AMENDMENT | 2022-10-31 | No data | No data |
| REINSTATEMENT | 2021-09-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-21 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-01-12 |
| Amendment | 2022-10-31 |
| ANNUAL REPORT | 2022-06-14 |
| REINSTATEMENT | 2021-09-27 |
| Domestic Profit | 2020-09-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
