| Entity Name: | UBALDO S. RODRIGUEZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 30 Jun 1980 (45 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | 677832 |
| FEI/EIN Number | 59-2007815 |
| Address: | 3375 W. 4TH AVENUE, HIALEAH, FL 33012 |
| Mail Address: | 3375 W. 4TH AVENUE, HIALEAH, FL 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851693865 | 2010-11-23 | 2010-11-23 | 3375 W 4TH AVE, HIALEAH, FL, 330124360, US | 3375 W 4TH AVE, HIALEAH, FL, 330124360, US | |||||||||||||||||||||||||
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| Phone | +1 305-557-4020 |
| Fax | 3058886114 |
Authorized person
| Name | DR. UBALDO S RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 3055574020 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 25253 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 059141600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, UBALDO SMD | Agent | 3375 WEST 4TH AVENUE, HIALEAH, FL 33012 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, UBALDO S. | Director | 3375 W 4TH AVENUE, HIALEAH,, FL 33012 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, UBALDO S. | Manager | 3375 W 4TH AVENUE, HIALEAH,, FL 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-18 | RODRIGUEZ, UBALDO SMD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-18 | 3375 WEST 4TH AVENUE, HIALEAH, FL 33012 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1993-05-01 | 3375 W. 4TH AVENUE, HIALEAH, FL 33012 | No data |
| CHANGE OF MAILING ADDRESS | 1993-05-01 | 3375 W. 4TH AVENUE, HIALEAH, FL 33012 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-03-03 |
| ANNUAL REPORT | 2014-02-25 |
| ANNUAL REPORT | 2013-02-27 |
| ANNUAL REPORT | 2012-04-27 |
| ANNUAL REPORT | 2011-02-24 |
| ANNUAL REPORT | 2010-04-26 |
| ANNUAL REPORT | 2009-03-18 |
| ANNUAL REPORT | 2008-04-24 |
| ANNUAL REPORT | 2007-04-20 |
| ANNUAL REPORT | 2006-04-10 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
