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  5. LIFE HEALTHCARE SERVICES, INC.

LIFE HEALTHCARE SERVICES, INC.

Company Details

Entity Name: LIFE HEALTHCARE SERVICES, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 06 Jan 1995 (30 years ago)
Document Number: P95000001448
FEI/EIN Number 650578671
Address: 2170 W. 73RD ST., HIALEAH, FL, 33016, US
Mail Address: 2170 W. 73RD ST., HIALEAH, FL, 33016, US
ZIP code: 33016
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1801209366 2014-06-03 2014-06-03 2170 W 73RD ST, HIALEAH, FL, 330161820, US 2170 W 73RD ST, HIALEAH, FL, 330161820, US

Contacts
Phone +1 305-826-5757
Fax 3058265767

Authorized person
Name RENE HERNANDEZ
Role CEO
Phone 3058265757

Taxonomy
Taxonomy Code 3336S0011X - Specialty Pharmacy
License Number PH28159
State FL
Is Primary Yes

Other Provider Identifiers
Issuer PK
Number 2146076

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LIFE HEALTHCARE SERVICES 401 K PROFIT SHARING PLAN TRUST 2013 650578671 2014-03-21 LIFE HEALTHCARE SERVICES 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058875757
Plan sponsor’s address 2170 W 73RD ST, HIALEAH, FL, 330161820

Signature of
Role Plan administrator
Date 2014-03-21
Name of individual signing RENE HERNANDEZ
Valid signature Filed with authorized/valid electronic signature
LIFE HEALTHCARE SERVICES 401 K PROFIT SHARING PLAN TRUST 2012 650578671 2013-07-30 LIFE HEALTHCARE SERVICES 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058875757
Plan sponsor’s address 2170 W 73RD ST, HIALEAH, FL, 330161820

Signature of
Role Plan administrator
Date 2013-07-30
Name of individual signing LIFE HEALTHCARE SERVICES
Valid signature Filed with authorized/valid electronic signature
LIFE HEALTHCARE SERVICES 401 K PROFIT SHARING PLAN TRUST 2011 650578671 2012-07-27 LIFE HEALTHCARE SERVICES 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058873737
Plan sponsor’s address 2170 W 73RD ST, HIALEAH, FL, 330161820

Plan administrator’s name and address
Administrator’s EIN 650578671
Plan administrator’s name LIFE HEALTHCARE SERVICES
Plan administrator’s address 2170 W 73RD ST, HIALEAH, FL, 330161820
Administrator’s telephone number 3058873737

Signature of
Role Plan administrator
Date 2012-07-27
Name of individual signing LIFE HEALTHCARE SERVICES
Valid signature Filed with authorized/valid electronic signature
LIFE HEALTHCARE SERVICES 401 K PROFIT SHARING PLAN TRUST 2010 650578671 2011-07-18 LIFE HEALTHCARE SERVICES 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058265757
Plan sponsor’s address 2170 W 73 STREET, HIALEAH, FL, 330160000

Plan administrator’s name and address
Administrator’s EIN 650578671
Plan administrator’s name LIFE HEALTHCARE SERVICES
Plan administrator’s address 2170 W 73 STREET, HIALEAH, FL, 330160000
Administrator’s telephone number 3058265757

Signature of
Role Plan administrator
Date 2011-07-18
Name of individual signing LIFE HEALTHCARE SERVICES
Valid signature Filed with authorized/valid electronic signature
LIFE HEALTHCARE SERVICES 401(K) PROFIT SHARING PLAN & TRUST 2009 650578671 2010-07-28 LIFE HEALTHCARE SERVICES, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058873737
Plan sponsor’s mailing address 2170 W 73 STREET, MIAMI, FL, 33016
Plan sponsor’s address 2170 W 73 STREET, MIAMI, FL, 33016

Plan administrator’s name and address
Administrator’s EIN 650578671
Plan administrator’s name LIFE HEALTHCARE SERVICES, INC.
Plan administrator’s address 2170 W 73 STREET, MIAMI, FL, 33016
Administrator’s telephone number 3058873737

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 2
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing RENE HERNANDEZ
Valid signature Filed with authorized/valid electronic signature
LIFE HEALTHCARE SERVICES 2009 650578671 2010-06-02 LIFE HEALTHCARE SERVICES INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058265757
Plan sponsor’s mailing address 2170 W 73 STREET, HIALEAH, FL, 33016
Plan sponsor’s address 2170 W 73 STREET, HIALEAH, FL, 33016

Plan administrator’s name and address
Administrator’s EIN 650578671
Plan administrator’s name LIFE HEALTHCARE SERVICES INC
Plan administrator’s address 2170 W 73 STREET, HIALEAH, FL, 33016
Administrator’s telephone number 3058265757

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 2
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-06-02
Name of individual signing RENE HERNANDEZ
Valid signature Filed with authorized/valid electronic signature
LIFE HEALTHCARE SERVICES 2009 650578671 2010-06-02 LIFE HEALTHCARE SERVICES 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621610
Sponsor’s telephone number 3058265757
Plan sponsor’s address 2170 W 73 STREET, MIAMI, FL, 330160000

Plan administrator’s name and address
Administrator’s EIN 650578671
Plan administrator’s name LIFE HEALTHCARE SERVICES
Plan administrator’s address 2170 W 73 STREET, MIAMI, FL, 330160000
Administrator’s telephone number 3058265757

Signature of
Role Plan administrator
Date 2010-06-02
Name of individual signing LIFE HEALTHCARE SERVICES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
LEONCIO & ASSOCIATES, LLC. Agent

President

Name Role Address
HERNANDEZ Eduviges President 2170 W. 73RD ST., HIALEAH, FL, 33016

Chief Executive Officer

Name Role Address
Hernandez Rene Chief Executive Officer 2170 W. 73RD ST., HIALEAH, FL, 33016

Chief Operating Officer

Name Role Address
Romero Hector Chief Operating Officer 2170 W. 73RD ST., HIALEAH, FL, 33016

Chief Financial Officer

Name Role Address
Leoncio Rene Chief Financial Officer 2170 W. 73RD ST., HIALEAH, FL, 33016

Secretary

Name Role Address
Hernandez Jessica Secretary 2170 W. 73RD ST., HIALEAH, FL, 33016

Events

Event Type Filed Date Value Description
REINSTATEMENT 2013-10-10 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 No data No data
AMENDMENT 2005-11-04 No data No data
AMENDMENT 1998-10-05 No data No data
NAME CHANGE AMENDMENT 1998-02-17 LIFE HEALTHCARE SERVICES, INC. No data
NAME CHANGE AMENDMENT 1997-11-14 MED-LIFE HEALTHCARE SERVICES, INC. No data
AMENDMENT 1997-03-10 No data No data
AMENDMENT AND NAME CHANGE 1996-06-05 MED-LIFE, INC. No data
NAME CHANGE AMENDMENT 1995-05-19 WORLD MEDICAL EQUIPMENT, INC. No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J04900003121 LAPSED 03-26462 CA 04 CIR CT MIAMI-DADE CO CRTHOUSE 2003-01-22 2009-02-05 $17249.76 SPEC MEDICAL, INC., 4654 S.W. 74TH AVENUE, MIAMI, FL 33155

Related by officers

Hernandez Rene

KARATE-DO ALLIANCE, INC. R & A CORAL WAY LLC SPECIALIZED PAINTING & MORE LLC PARTIDO DEMOCRATA CRISTIANO DE CUBA CORP.

Hernandez Jessica

THE ACHIEVA FOUNDATION, CORPORATION PEREIRA FOUNDATION CORP FRELZI INTERNATIONAL LLC XTREME ALL-STARS, LLC CNF EARTHWORKS LLC NAILS & VIBES LLC ATLANTIC GOOD SERVICES, INC.

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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