| Entity Name: | MAIMONIDES MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Mar 1996 (29 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Apr 2015 (10 years ago) |
| Document Number: | P96000024589 |
| FEI/EIN Number | 650660219 |
| Address: | 1295 SOUTH US 1, ROCKLEDGE, FL, 32955, US |
| Mail Address: | 1295 SOUTH US 1, ROCKLEDGE, FL, 32955, US |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477514651 | 2006-03-29 | 2012-12-04 | 1295 S US HIGHWAY 1, ROCKLEDGE, FL, 329552732, US | 1295 S US HIGHWAY 1, ROCKLEDGE, FL, 329552732, US | |||||||||||||||||||||||||
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| Phone | +1 321-637-6654 |
| Fax | 3214331119 |
Authorized person
| Name | DR. CAROLINA C SARENAS |
| Role | VICE-PRESIDENT |
| Phone | 3216376654 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 379714700 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MAIMONIDES MEDICAL CENTER INC PROFIT SHARING | 2009 | 650660219 | 2010-10-14 | MAIMONIDES MEDICAL CENTER INC | 5 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 650660219 |
| Plan administrator’s name | MAIMONIDES MEDICAL CENTER INC |
| Plan administrator’s address | 1295 SOUTH US 1, ROCKLEDGE, FL, 32955 |
| Administrator’s telephone number | 3216376654 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-14 |
| Name of individual signing | CAROLINA SARENAS, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SARENAS CAROLINA | Agent | 1295 SOUTH US 1, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| SARENAS CAROLINA | Vice President | 3210 GATLIN DR, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| VERGARA GERMAN | President | 3210 GATLIN DR, ROCKLEDGE, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2015-04-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-27 | SARENAS, CAROLINA | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-16 | 1295 SOUTH US 1, ROCKLEDGE, FL 32955 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-02-08 | 1295 SOUTH US 1, ROCKLEDGE, FL 32955 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-02-08 | 1295 SOUTH US 1, ROCKLEDGE, FL 32955 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-20 |
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-01-03 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-06 |
| ANNUAL REPORT | 2019-01-08 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-20 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
