| Entity Name: | GOLDENCARE HOME HEALTH AGENCY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Oct 1995 (29 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 31 Jul 2024 (6 months ago) |
| Document Number: | P95000082906 |
| FEI/EIN Number | 650620020 |
| Address: | 780 NW 42ND AVE, MIAMI, FL, 33126-5536, US |
| Mail Address: | 780 NW 42ND AVE, MIAMI, FL, 33126-5536, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588865927 | 2007-05-31 | 2024-04-03 | 780 NW 42ND AVE STE 300, MIAMI, FL, 331265536, US | 780 NW 42ND AVE STE 300, MIAMI, FL, 331265536, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-553-2553 |
| Fax | 3055535321 |
Authorized person
| Name | ELIZABETH BRACERAS CAMPO |
| Role | PRESIDENT/ ADMIN. |
| Phone | 3058638860 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 22015096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID WAIVER |
| Number | 688049500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 651052300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ AYMEE | Agent | 780 NW 42ND AVE, MIAMI, FL, 331265536 |
| Name | Role | Address |
|---|---|---|
| BRACERAS ELIZABETH | Director | 780 NW 42ND AVE, MIAMI, FL, 331265536 |
| Braceras Gisele B | Director | 780 NW 42ND AVE, MIAMI, FL, 331265536 |
| Name | Role |
|---|---|
| GEB LLC | Officer |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2024-07-31 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-27 | 780 NW 42ND AVE, 300, MIAMI, FL 33126-5536 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-27 | 780 NW 42ND AVE, 300, MIAMI, FL 33126-5536 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-27 | 780 NW 42ND AVE, 300, MIAMI, FL 33126-5536 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-27 | FERNANDEZ, AYMEE | No data |
| Name | Date |
|---|---|
| Amendment | 2024-07-31 |
| ANNUAL REPORT | 2024-03-27 |
| AMENDED ANNUAL REPORT | 2023-11-29 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-02-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
