| Entity Name: | AXEN HEALTH, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Jul 2022 (3 years ago) |
| Document Number: | P22000058425 |
| FEI/EIN Number | 92-0255783 |
| Address: | 2103 CORAL WAY, SUITE 200, MIAMI, FL 33145 |
| Mail Address: | 2103 CORAL WAY, SUITE 200, MIAMI, FL 33145 |
| ZIP code: | 33145 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568153310 | 2023-05-15 | 2023-05-15 | 2103 CORAL WAY, 2ND FLOOR, CORAL GABLES, FL, 33145, US | 10621 N KENDALL DR STE 211, MIAMI, FL, 331761530, US | |||||||||||||||
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| Phone | +1 305-596-4288 |
| Fax | 7867033571 |
Authorized person
| Name | MR. MICHAEL SELLINGER |
| Role | CFO |
| Phone | 9175147007 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BURDETTE, WILLIAM R | Agent | 2103 CORAL WAY, SUITE 200, MIAMI, FL 33145 |
| Name | Role | Address |
|---|---|---|
| De Jesus, Ivan Dynamo | Chief Executive Officer | 2103 Coral Way, 2nd Floor Coral Gables, FL 33145 |
| Name | Role | Address |
|---|---|---|
| De Jesus, Ivan Dynamo | Founder | 2103 Coral Way, 2nd Floor Coral Gables, FL 33145 |
| Name | Role | Address |
|---|---|---|
| BURDETTE, WILLIAM R | Senior Vice President | 2103 CORAL WAY, MIAMI, FL 33145 UN |
| Name | Role | Address |
|---|---|---|
| BURDETTE, WILLIAM R | Director | 2103 CORAL WAY, MIAMI, FL 33145 UN |
| Name | Role | Address |
|---|---|---|
| Sellinger, Michael Scott | Chief Financial Officer | 2103 Coral Way, 2nd Floor Coral Gables, FL 33145 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-25 |
| Domestic Profit | 2022-07-21 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
