| Entity Name: | KENDALL PEDIATRICS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 26 Jul 1990 (35 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L89199 |
| FEI/EIN Number | 65-0208375 |
| Address: | 11400 NORTH KENDALL DRIVE #A211, A211, MIAMI, FL 33176 |
| Mail Address: | 11400 NORTH KENDALL DRIVE #A211, A211, MIAMI, FL 33176 |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497885834 | 2007-03-06 | 2009-09-24 | 11400 N KENDALL DR, SUITE A211, MIAMI, FL, 331761029, US | 11400 N KENDALL DR, SUITE A211, MIAMI, FL, 331761029, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-274-2255 |
| Fax | 3052742211 |
Authorized person
| Name | DR. GUILLERMO JUAN LLOSA |
| Role | OWNER |
| Phone | 3052742255 |
Taxonomy
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| License Number | ME 38885 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 275521100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 275116000 |
| State | FL |
| Issuer | NPI ALINA SIBLESZ RUIZ MD |
| Number | 1063475887 |
| State | FL |
| Issuer | NPI GUILLERMO LLOSA, MD |
| Number | 1720077308 |
| State | FL |
| Issuer | MEDICAID |
| Number | 266165900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LLOSA, GUILLERMO | Agent | 11400 NORTH KENDALL DRIVE, #A211, MIAMI, FL 33176 |
| Name | Role | Address |
|---|---|---|
| LLOSA, GUILLERMO | Director | 11400 N. KENDALL DR#A211, MIAMI, FL 33176 |
| SIBLESZ RUIZ, ALINA | Director | 11400 N. KENDALL DR#A211, MIAMI, FL 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-06-07 | LLOSA, GUILLERMO | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-31 | 11400 NORTH KENDALL DRIVE #A211, A211, MIAMI, FL 33176 | No data |
| CHANGE OF MAILING ADDRESS | 2011-03-31 | 11400 NORTH KENDALL DRIVE #A211, A211, MIAMI, FL 33176 | No data |
| NAME CHANGE AMENDMENT | 2009-09-03 | KENDALL PEDIATRICS, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-03-29 |
| ANNUAL REPORT | 2013-01-28 |
| ANNUAL REPORT | 2012-02-08 |
| ANNUAL REPORT | 2011-06-07 |
| ANNUAL REPORT | 2011-03-31 |
| ANNUAL REPORT | 2010-02-23 |
| Name Change | 2009-09-03 |
| ANNUAL REPORT | 2009-04-13 |
| ANNUAL REPORT | 2008-03-20 |
| ANNUAL REPORT | 2007-03-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
