| Entity Name: | PEREZ HOME CARE CORPORATION |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 03 Dec 1997 (27 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | P97000102692 |
| FEI/EIN Number | 65-0798691 |
| Address: | 21201 NE 13TH PLACE, MIAMI, FL 33179 |
| Mail Address: | 400 south Hollybrook dr, 103, Pembroke Pines, FL 33025 |
| ZIP code: | 33179 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962616557 | 2007-05-10 | 2012-01-28 | 21201 NE 13TH PL, NORTH MIAMI BEACH, FL, 331791323, US | 21201 NE 13TH PL, NORTH MIAMI BEACH, FL, 331791323, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 305-652-8152 |
Authorized person
| Name | BLANCA PEREZ |
| Role | PRESIDENT |
| Phone | 3056528152 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 5787 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3104A0625X - Assisted Living Facility (Mental Illness) |
| License Number | 5787 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 141009100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEREZ, BLANCA | Agent | 21201 NE 13TH PLACE, MIAMI, FL 33179 |
| Name | Role | Address |
|---|---|---|
| PEREZ, BLANCA | President | 21201 NE 13TH PLACE, NORTH MIAMI BEACH, FL 33179 |
| Name | Role | Address |
|---|---|---|
| HUMPHREYS, SHAWN C | Vice President | 21201 NE 13TH PLACE, NORTH MIAMI BEACH, FL 33179 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000030151 | MOUNT SINAI HOME CARE | ACTIVE | 2022-02-28 | 2027-12-31 | No data | 21201 NE 13TH PLACE, MIAMI, FL, 33179 |
| G18000040324 | MOUNTAIN SINAI HOME CARE | EXPIRED | 2018-03-27 | 2023-12-31 | No data | 21201 NE 13TH PLACE, MIAMI, FL, 33179 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-10-07 | 21201 NE 13TH PLACE, MIAMI, FL 33179 | No data |
| CHANGE OF MAILING ADDRESS | 2022-10-07 | 21201 NE 13TH PLACE, MIAMI, FL 33179 | No data |
| AMENDMENT | 2021-05-11 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-05-11 | 21201 NE 13TH PLACE, MIAMI, FL 33179 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-04-20 |
| Amendment | 2021-05-11 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-05-27 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-20 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
