| Entity Name: | MANUEL J. BACALLAO, M.D., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Sep 2003 (21 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L03000034429 |
| FEI/EIN Number | 200257390 |
| Address: | 8525 SW 92 ST., MIAMI, FL, 33156, US |
| Mail Address: | 8525 SW 92 ST., MIAMI, FL, 33156, US |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275882904 | 2012-09-10 | 2012-09-13 | 8525 SW 92ND ST, SUITE B-4, MIAMI, FL, 331567365, US | 8525 SW 92ND ST, SUITE B-4, MIAMI, FL, 331567365, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 305-279-7446 |
| Fax | 3055988753 |
Authorized person
| Name | DR. MANUEL J BACALLAO |
| Role | PHYSICIAN |
| Phone | 3052797446 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0038837 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ELLIS SETH EEsq. | Agent | THERREL BAISDEN, ESQ, MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| BACALLAO MANUEL JMD | Manager | 8525 SW 92 ST., MIAMI, FL, 33156 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-02-19 | 8525 SW 92 ST., STE. B-4, MIAMI, FL 33156 | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-19 | 8525 SW 92 ST., STE. B-4, MIAMI, FL 33156 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-02-19 | ELLIS, SETH E., Esq. | No data |
| REINSTATEMENT | 2017-09-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-01-26 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-02-19 |
| REINSTATEMENT | 2017-09-28 |
| ANNUAL REPORT | 2016-03-06 |
| ANNUAL REPORT | 2015-04-12 |
| ANNUAL REPORT | 2014-06-29 |
| ANNUAL REPORT | 2013-04-14 |
| ANNUAL REPORT | 2012-06-03 |
| ANNUAL REPORT | 2011-04-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
