| Entity Name: | RIELO DENTAL CLINIC, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Oct 2022 (2 years ago) |
| Document Number: | L22000429464 |
| FEI/EIN Number | 88-4154958 |
| Address: | 5376 W 16TH AVE, HIALEAH, FL, 33012, US |
| Mail Address: | 5376 W 16TH AVE, HIALEAH, FL, 33012, US |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578272548 | 2022-11-18 | 2022-11-18 | 5376 W 16TH AVE, HIALEAH, FL, 330122165, US | 5376 W 16TH AVE, HIALEAH, FL, 330122165, US | |||||||||||||||||||||
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| Phone | +1 305-231-5455 |
| Fax | 3057490980 |
Authorized person
| Name | DR. MIGUEL A RIELO |
| Role | OWNER/DENTIST |
| Phone | 7863751782 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103860400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LORES & ASSOCIATES, CORP | Agent | 8785 sw 165 ave, MIAMI, FL, 33193 |
| Name | Role | Address |
|---|---|---|
| RIELO MIGUEL A | President | 13030 SW 116 ST, HIALEAH, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-01 | 8785 sw 165 ave, Suite 103, MIAMI, FL 33193 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-02 |
| Florida Limited Liability | 2022-10-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
