| Entity Name: | RAFAEL GARCIA, M.D., M.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Jul 2000 (25 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P00000066244 |
| FEI/EIN Number | 651022845 |
| Address: | 705 EAST 8 AVE., SUITE 101, HIALEAH, FL, 33010-4613, US |
| Mail Address: | 705 EAST 8 AVE., SUITE 101, HIALEAH, FL, 33010-4613, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790091882 | 2010-08-26 | 2010-08-26 | 705 E 8TH AVE, HIALEAH, FL, 330104613, US | 705 E 8TH AVE, HIALEAH, FL, 330104613, US | |||||||||||||||||||||||
|
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| Phone | +1 305-603-9751 |
Authorized person
| Name | DR. RAFAEL GARCIA |
| Role | OWNER PHYSICIAN |
| Phone | 3056039751 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME77010 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 258717300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BANOS JAVIER | Agent | 3128 CORAL WAY, MIAMI, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| GARCIA RAFAEL | President | 705 E 8TH AVE.STE 101, HIALEAH, FL, 33010 |
| Name | Role | Address |
|---|---|---|
| GARCIA RAFAEL | Treasurer | 705 E 8TH AVE.STE 101, HIALEAH, FL, 33010 |
| Name | Role | Address |
|---|---|---|
| GARCIA RAFAEL | Director | 705 E 8TH AVE.STE 101, HIALEAH, FL, 33010 |
| Name | Role | Address |
|---|---|---|
| PAZOS FLORA | Vice President | 705 EAST 8TH AVE. STE 101, HIALEAH, FL, 33010 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| AMENDMENT | 2013-03-01 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-09-09 | 705 EAST 8 AVE., SUITE 101, HIALEAH, FL 33010-4613 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-09-09 | 705 EAST 8 AVE., SUITE 101, HIALEAH, FL 33010-4613 | No data |
| AMENDMENT | 2010-09-09 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-17 | 3128 CORAL WAY, MIAMI, FL 33145 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-02-08 | BANOS, JAVIER | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-15 |
| Amendment | 2013-03-01 |
| ANNUAL REPORT | 2012-04-19 |
| ANNUAL REPORT | 2011-04-08 |
| Amendment | 2010-09-09 |
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-17 |
| ANNUAL REPORT | 2008-02-08 |
| ANNUAL REPORT | 2007-04-19 |
| ANNUAL REPORT | 2006-04-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
