| Entity Name: | HI-5 CHILDREN'S DENTISTRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Jul 2013 (12 years ago) |
| Document Number: | L13000107805 |
| FEI/EIN Number | 46-3323630 |
| Address: | 1202 CYPRESS GLEN CIR, KISSIMMEE, FL, 34741, US |
| Mail Address: | 11912 YELLOW FIN TRL, ORLANDO, FL, 32827, US |
| ZIP code: | 34741 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609296276 | 2014-04-22 | 2014-04-22 | 11912 YELLOW FIN TRL, ORLANDO, FL, 328277138, US | 1202 CYPRESS GLEN CIR, KISSIMMEE, FL, 347417563, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-810-0467 |
| Phone | +1 407-810-0450 |
Authorized person
| Name | MIGUEL TABARES |
| Role | PRESIDENT |
| Phone | 4078100467 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | DN19471 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 21540 |
| State | FL |
| Name | Role |
|---|---|
| ANDINO CONSULTING GROUP INC | Agent |
| Name | Role | Address |
|---|---|---|
| TABARES MIGUEL R | Managing Member | 11912 YELLOW FIN TRL, ORLANDO, FL, 32827 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000103184 | HI-5 CHILDREN'S DENTISTRY | EXPIRED | 2017-09-15 | 2022-12-31 | No data | 1202 CYPRESS GLEN CIR, KISSIMMEE, FL, 34741 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-03 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-01-14 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-03-09 |
| ANNUAL REPORT | 2016-03-06 |
| ANNUAL REPORT | 2015-01-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
