| Entity Name: | CLAUDIO L. MIRO., D.D.S. CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Feb 1990 (35 years ago) |
| Document Number: | L53672 |
| FEI/EIN Number | 650180426 |
| Address: | 564 SW 42 AVE 2ND FLOOR, MIAMI, FL, 33134 |
| Mail Address: | 564 SW 42 AVE 2ND FLOOR, MIAMI, FL, 33134 |
| ZIP code: | 33134 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962851634 | 2016-06-03 | 2016-06-03 | 564 SW 42ND AVE FL 2, CORAL GABLES, FL, 331341962, US | 564 SW 42ND AVE FL 2, CORAL GABLES, FL, 331341962, US | |||||||||||||||||||||||||
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| Phone | +1 305-442-7444 |
| Fax | 3054457771 |
Authorized person
| Name | MARIA E CARBAJAL |
| Role | OFFICE MANAGER |
| Phone | 3054427444 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN11650 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014663700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MIRO CLAUDIO | Agent | 564 SW 42 AVE 2ND FLOOR, MIAMI, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| MIRO CLAUDIO L | DDS | 564 SW 42 AVE 2ND FLOOR, MIAMI, FL, 33134 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000029298 | MIRO DENTAL CENTER | ACTIVE | 2016-03-21 | 2026-12-31 | No data | 564 SW 42 AVE 2ND FLOOR, MIAMI, FL, 33134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 1991-01-25 | CLAUDIO L. MIRO., D.D.S. CORP | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001063511 | TERMINATED | 1000000501532 | DADE | 2013-05-10 | 2023-06-07 | $ 1,010.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
