| Entity Name: | EMILIO DEL VALLE, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Oct 2000 (24 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P00000102422 |
| FEI/EIN Number | 651055486 |
| Address: | 6300 CORPORATE CT, STE 103, FORT MYERS, FL, 33919, US |
| Mail Address: | 6300 CORPORATE CT, STE 103, FORT MYERS, FL, 33919, US |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518088517 | 2007-04-03 | 2018-04-19 | 1860 BOY SCOUT DR STE 201, FORT MYERS, FL, 339072119, US | 6300 CORPORATE CT STE 103, FORT MYERS, FL, 339193513, US | |||||||||||||||||||||||||||||
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| Phone | +1 239-215-1180 |
| Fax | 2392151179 |
| Phone | +1 239-277-7666 |
| Fax | 2392771064 |
Authorized person
| Name | DR. EMILIO DEL VALLE |
| Role | PRESIDENT |
| Phone | 2392777666 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME55848 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 267778400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DEL VALLE EMILIO | Agent | 6300 CORPORATE CT, FORT MYERS, FL, 33919 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE EMILIO | President | 6300 CORPORATE CT, FORT MYERS, FL, 33919 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE EMILIO | Director | 6300 CORPORATE CT, FORT MYERS, FL, 33919 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2018-11-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-11-06 | 6300 CORPORATE CT, STE 103, FORT MYERS, FL 33919 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-11-06 | 6300 CORPORATE CT, STE 103, FORT MYERS, FL 33919 | No data |
| CHANGE OF MAILING ADDRESS | 2018-11-06 | 6300 CORPORATE CT, STE 103, FORT MYERS, FL 33919 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-11-06 | DEL VALLE, EMILIO | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000379337 | ACTIVE | 1000000997248 | LEE | 2024-06-10 | 2034-06-19 | $ 677.12 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| J22000264087 | ACTIVE | 1000000923912 | LEE | 2022-05-27 | 2032-06-01 | $ 1,807.12 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2018-11-06 |
| ANNUAL REPORT | 2017-01-26 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-27 |
| ANNUAL REPORT | 2014-01-22 |
| ANNUAL REPORT | 2013-02-18 |
| ANNUAL REPORT | 2012-03-13 |
| ANNUAL REPORT | 2011-02-25 |
| ANNUAL REPORT | 2010-01-29 |
| ANNUAL REPORT | 2009-07-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
