| Entity Name: | VILLA SERENA 1, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Dec 1996 (28 years ago) |
| Document Number: | P96000102946 |
| FEI/EIN Number | 650723856 |
| Address: | 1200 SW 22nd Terrace, Miami, FL, 33145, US |
| Mail Address: | 754-756 NW, 22nd Court, Miami, FL, 33125, US |
| ZIP code: | 33145 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497029516 | 2012-03-07 | 2012-03-07 | 701 SW 27TH AVE, MIAMI, FL, 331353031, US | 1200 SW 22ND TER, MIAMI, FL, 331453937, US | |||||||||||||||||||||
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| Phone | +1 305-206-5342 |
| Fax | 3056311124 |
Authorized person
| Name | ROXANA SOLANO |
| Role | OWNER |
| Phone | 3052065342 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140588800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Munoz Santos R | Agent | 754-756 NW, 22nd Court, Miami, FL, 33125 |
| Name | Role | Address |
|---|---|---|
| SOLANO ROXANA | President | 754-756 NW 22nd Court, Miami, FL, 33125 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| AMENDMENT AND NAME CHANGE | 2011-03-14 | VILLA SERENA 1, INC. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
