| Entity Name: | MIAMI CARDIOVASCULAR PREVENTION INSTITUTE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Jul 2007 (18 years ago) |
| Date of dissolution: | 06 Jun 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 06 Jun 2017 (8 years ago) |
| Document Number: | L07000078030 |
| FEI/EIN Number | 261889447 |
| Address: | 6419 BIRD ROAD, MIAMI, FL, 33155 |
| Mail Address: | 6419 BIRD ROAD, MIAMI, FL, 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720391287 | 2010-07-26 | 2010-07-26 | PO BOX 144396, CORAL GABLES, FL, 33114, US | 6419 SW BIRD ROAD, MIAMI, FL, 33155, US | |||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-774-5677 |
| Fax | 3057745697 |
Authorized person
| Name | MINERVA SANTOTOMAS |
| Role | PHYSICIAN |
| Phone | 3057745677 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME0043067 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME70314 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 254617500 |
| State | FL |
| Issuer | BC/BS |
| Number | 96497 |
| Issuer | MEDICAID |
| Number | 047928400 |
| State | FL |
| Issuer | BC/BS |
| Number | 32733 |
| Name | Role | Address |
|---|---|---|
| SANTO TOMAS MINERVA | Agent | 6419 BIRD ROAD, MIAMI, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| MINERVA SANTO-TOMAS | Managing Member | 6419 BIRD ROAD, MIAMI, FL, 33155 |
| CARMEN C FERNANDEZ | Managing Member | 6419 BIRD ROAD, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-06-06 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-19 | SANTO TOMAS, MINERVA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-19 | 6419 BIRD ROAD, MIAMI, FL 33155 | No data |
| REINSTATEMENT | 2009-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-05-07 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-03-15 |
| ANNUAL REPORT | 2011-04-19 |
| ANNUAL REPORT | 2010-04-27 |
| REINSTATEMENT | 2009-10-18 |
| ANNUAL REPORT | 2008-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
