| Entity Name: | DR. OSCAR L. HERNANDEZ, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Apr 2010 (15 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L10000042062 |
| FEI/EIN Number | 650248238 |
| Address: | 14221 SW 120TH ST, 129, MIAMI, FL, 33186 |
| Mail Address: | 14221 SW 120TH ST, 129, MIAMI, FL, 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083699490 | 2005-12-08 | 2012-07-31 | 14221 SW 120TH ST, STE 129, MIAMI, FL, 33186, US | 14221 SW 120TH ST, STE 129, MIAMI, FL, 33186, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-279-1515 |
| Fax | 3052791219 |
Authorized person
| Name | MR. OSCAR L HERNANDEZ SR. |
| Role | PRESIDENT/OWNER |
| Phone | 3052791515 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME57645 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME57645 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 063586300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ YADIRA | Agent | 14221 SW 120TH ST #129, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ OSCAR L | Manager | 14221 SW 120TH ST #129, MIAMI, FL, 33186 |
| HERNANDEZ YADIRA | Manager | 14221 SW 120TH ST #129, MIAMI, FL, 33186 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000114834 | BASIC MED EXAMS IN MIAMI | EXPIRED | 2018-10-23 | 2023-12-31 | No data | 14221 SW 120TH ST, SUITE #129, MIAMI, FL, 33186 |
| G16000019941 | METRO MED DIRECT CARE | EXPIRED | 2016-02-24 | 2021-12-31 | No data | 14221 SW 120TH ST, SUITE #129, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-26 | 14221 SW 120TH ST, 129, MIAMI, FL 33186 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-26 | 14221 SW 120TH ST, 129, MIAMI, FL 33186 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-26 | HERNANDEZ, YADIRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-26 | 14221 SW 120TH ST #129, MIAMI, FL 33186 | No data |
| CONVERSION | 2010-04-19 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS S29145. CONVERSION NUMBER 100000104421 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-17 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
