| Entity Name: | MIAMI GYNECOLOGIC ONCOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 28 Jul 2008 (17 years ago) |
| Date of dissolution: | 16 Mar 2018 (7 years ago) |
| Last Event: | PENDING REINSTATEMENT |
| Event Date Filed: | 16 Mar 2018 (7 years ago) |
| Document Number: | L08000072641 |
| FEI/EIN Number | 263106264 |
| Address: | 851 HUNTING LODGE DR, MIAMI SPRINGS, FL, 33166 |
| Mail Address: | PO BOX 661132, MIAMI SPRINGS, FL, 33166 |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265689459 | 2008-08-19 | 2008-08-19 | 1030 REDBIRD AVE, MIAMI SPRINGS, FL, 331663223, US | 7100 W 20TH AVE, SUITE 702, HIALEAH, FL, 330161897, US | |||||||||||||||||||||||||
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| Phone | +1 305-828-8688 |
| Fax | 3058288655 |
Authorized person
| Name | DR. EMERY MANUEL SALOM |
| Role | OWNER |
| Phone | 3058288688 |
Taxonomy
| Taxonomy Code | 207VX0201X - Gynecologic Oncology Physician |
| License Number | ME77021 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2707900 00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EMERY SALOM | Agent | 851 HUNTING LODGE DR, MIAMI SPRINGS, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| SALOM EMERY | Manager | PO BOX 661132, MIAMI SPRINGS, FL, 33166 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000014506 | MGO | EXPIRED | 2010-02-14 | 2015-12-31 | No data | 7150 WEST 20TH AVE, SUITE 614, HIALEAH, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REINSTATEMENT | 2014-06-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-11-25 | 851 HUNTING LODGE DR, MIAMI SPRINGS, FL 33166 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-11-25 | EMERY SALOM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-11-25 | 851 HUNTING LODGE DR, MIAMI SPRINGS, FL 33166 | No data |
| REINSTATEMENT | 2012-11-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-11-25 | 851 HUNTING LODGE DR, MIAMI SPRINGS, FL 33166 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2012-11-25 |
| ANNUAL REPORT | 2011-09-11 |
| ANNUAL REPORT | 2010-02-14 |
| ANNUAL REPORT | 2009-04-25 |
| Florida Limited Liability | 2008-07-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
