| Entity Name: | CORAL WAY DENTAL CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 13 Mar 1989 (36 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Apr 2022 (3 years ago) |
| Document Number: | K72432 |
| FEI/EIN Number | 65-0110125 |
| Address: | 9644 SW 24 STREET, MIAMI, FL 33165 |
| Mail Address: | 9644 SW 24 STREET, MIAMI, FL 33165 |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508107871 | 2013-03-11 | 2013-03-11 | 9644 SW 24TH ST, MIAMI, FL, 331658015, US | 9644 SW 24TH ST, MIAMI, FL, 331658015, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-227-0155 |
| Fax | 3052270189 |
Authorized person
| Name | MRS. YOLANDA BAEZ |
| Role | OWNER |
| Phone | 3052270155 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | DN 11420 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 073149800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Baez, Yolanda | Agent | 9644 SW 24 ST, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| BAEZ, YOLANDA E. | Secretary | 9644 SW 24 ST, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| BAEZ, YOLANDA E. | Treasurer | 9644 SW 24 ST, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| BAEZ, YOLANDA E. | Director | 9644 SW 24 ST, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| BAEZ, YOLANDA E. | President | 9644 SW 24 ST, MIAMI, FL 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-04-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-27 | Baez, Yolanda | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2002-05-24 | 9644 SW 24 STREET, MIAMI, FL 33165 | No data |
| CHANGE OF MAILING ADDRESS | 2002-05-24 | 9644 SW 24 STREET, MIAMI, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-04-19 |
| REINSTATEMENT | 2022-04-27 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-08 |
| ANNUAL REPORT | 2017-06-30 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-01-20 |
| ANNUAL REPORT | 2014-02-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
