| Entity Name: | DOS OF PALM BEACH INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Nov 2000 (24 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | P00000103811 |
| FEI/EIN Number | 65-1052547 |
| Address: | 300 71ST STREET STE 410, MIAMI BEACH, FL 33141 |
| Mail Address: | 300 71ST STREET STE 410, MIAMI BEACH, FL 33141 |
| ZIP code: | 33141 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679667158 | 2006-10-02 | 2020-08-22 | 1101 54 STREET, WEST PALM BEACH, FL, 334072419, US | 1101 54 STREET, WEST PALM BEACH, FL, 334072419, US | |||||||||||||||||||||||||
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| Phone | +1 561-844-8401 |
| Fax | 5618424658 |
Authorized person
| Name | MR. JORGE R HERNANDO |
| Role | CFO |
| Phone | 5618448401 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1266096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | N53 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARBIN, EVAN R | Agent | 48 EAST FLAGLER STREET, PH-104, MIAMI, FL 33131 |
| Name | Role | Address |
|---|---|---|
| HERNANDO, JORGE R | Director | 300 71ST STREET STE 410, MIAMI BEACH, FL 33141 |
| HERNANDO, EDUARDO R | Director | 300 71ST STREET STE 410, MIAMI BEACH, FL 33141 |
| HERNANDO, JORGE A | Director | 300 71ST STREET STE 410, MIAMI BEACH, FL 33141 |
| ANTONACCI, NICHOLAS C | Director | 300 71ST STREET STE 410, MIAMI BEACH, FL 33141 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-04-26 | MARBIN, EVAN R | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-26 | 48 EAST FLAGLER STREET, PH-104, MIAMI, FL 33131 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-04-26 |
| ANNUAL REPORT | 2006-04-28 |
| ANNUAL REPORT | 2005-07-08 |
| ANNUAL REPORT | 2004-04-28 |
| ANNUAL REPORT | 2003-09-10 |
| ANNUAL REPORT | 2002-05-13 |
| ANNUAL REPORT | 2001-05-03 |
| Domestic Profit | 2000-11-06 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
