| Entity Name: | MIAMI CARDIOPULMONARY INSTITUTE, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 01 Jun 2001 (24 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L01000008876 |
| FEI/EIN Number | 651119017 |
| Address: | 3200 PONCE DE LEON BOULEVARD, CORAL GABLES, FL, 33134, US |
| Mail Address: | 3200 PONCE DE LEON BOULEVARD, CORAL GABLES, FL, 33134, US |
| ZIP code: | 33134 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1306849773 | 2005-05-31 | 2018-06-20 | 3200 PONCE DE LEON BLVD, CORAL GABLES, FL, 331347239, US | 3200 PONCE DE LEON BLVD, CORAL GABLES, FL, 331347239, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-448-9990 |
| Fax | 3054489993 |
Authorized person
| Name | DR. ILDEFONSO J MAS JR. |
| Role | PRESIDENT/MEDICAL DIRECTOR |
| Phone | 3054489990 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | N/A-OP CARDIAC CATH |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 268091200 |
| State | FL |
| Issuer | NEIGHBORHOOD HEALTH PLAN |
| Number | 45678 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | V2751 |
| State | FL |
| Issuer | AETNA HMO |
| Number | 3321067 |
| State | FL |
| Issuer | AETNA |
| Number | 3556558 |
| State | FL |
| Issuer | AETNA NON-HMO |
| Number | 7388537 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | V3352 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD (CATH) |
| Number | V3352 |
| State | FL |
| Issuer | AVMED |
| Number | 291498 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MAS JR ILDEFONSO | Agent | 3181 CORAL WAY, CORAL GABLES, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| MAS JR. ILDEFONSO P | President | 3181 CORAL WAY, 5TH FLOOR, CORAL GABLES, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| PALOMO ANDRES | Treasurer | 7171 S.W. 62ND AVE., #301, MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| CENTURION JOSE J | Secretary | 4625 Ponce De Leon Blvd, CORAL GABLES, FL, 33146 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-02-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-13 | MAS JR, ILDEFONSO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-13 | 3181 CORAL WAY, 5TH FLOOR, CORAL GABLES, FL 33145 | No data |
| NAME CHANGE AMENDMENT | 2003-01-31 | MIAMI CARDIOPULMONARY INSTITUTE, L.L.C. | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2022-02-26 |
| REINSTATEMENT | 2022-02-17 |
| ANNUAL REPORT | 2020-02-13 |
| ANNUAL REPORT | 2019-01-28 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-01-26 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-03-17 |
| ANNUAL REPORT | 2014-03-19 |
| ANNUAL REPORT | 2013-01-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
