| Entity Name: | BWELL MEDICAL CENTER INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 15 Nov 2022 (2 years ago) |
| Document Number: | P22000086412 |
| FEI/EIN Number | 92-1086266 |
| Address: | 10500 NW 26TH ST, SUITE A102A, DORAL, FL 33172 |
| Mail Address: | 10500 NW 26TH ST, SUITE A102A, DORAL, FL 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124738539 | 2022-11-28 | 2022-11-28 | 10500 NW 26TH ST STE A102, DORAL, FL, 331722158, US | 10500 NW 26TH ST STE A102, DORAL, FL, 331722158, US | |||||||||||||
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| Phone | +1 305-646-1799 |
Authorized person
| Name | EILEEN SHIELDS JIMENEZ |
| Role | CEO/OWNER |
| Phone | 3059514499 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHIELDS-JIMENEZ, EILEEN | Agent | 1660 SW 145 AVE, MIAMI, FL, FL 33175 |
| Name | Role | Address |
|---|---|---|
| SHIELDS-JIMENEZ, EILEEN | President | 1660 SW 145 AVE, MIAMI, FL 33175 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-27 |
| Domestic Profit | 2022-11-15 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
