| Entity Name: | LUIS PHARMACY,INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Apr 1965 (60 years ago) |
| Document Number: | 292122 |
| FEI/EIN Number | 591092146 |
| Address: | 3442 S.W. 8 ST, MIAMI, FL, 33135, US |
| Mail Address: | 3442 S.W. 8th Street, MIAMI, FL, 33135, US |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801989298 | 2006-09-30 | 2014-01-31 | 3601 SW 8TH ST, MIAMI, FL, 331354111, US | 3601 SW 8TH ST, MIAMI, FL, 331354111, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 305-445-5393 |
| Fax | 3055299093 |
Authorized person
| Name | MIRIAM MARTINEZ |
| Role | PRESIDENT AND CEO |
| Phone | 3054455393 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH2691 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102334901 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZAIAC, MANUEL | Agent | 150 S.E. 2ND AVE, MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ MIRIAM | President | 3442 SOUTHWEST 8TH STREET, MIAMI, FL, 33135 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ ANTONIO | Secretary | 3442 SOUTHWEST 8TH STREET, MIAMI, FL, 33135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 1973-05-24 | LUIS PHARMACY,INC. | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000272908 | LAPSED | 17-000277 SP 26 04 | MIAMI-DADE COUNTY | 2017-04-17 | 2022-05-17 | $5,483.91 | GENETCO, INC., 71 UNION PARKWAY, RONKONKOMA, NEW YORK 11779 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
