| Entity Name: | SALAZAR FAMILY HEALTH CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 Dec 2000 (24 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P00000114064 |
| FEI/EIN Number | 593686278 |
| Address: | 1310 N. CHURCH AVE, MULBERRY, FL, 33860 |
| Mail Address: | PO BOX 1312, MULBERRY, FL, 33860 |
| ZIP code: | 33860 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437141686 | 2005-08-15 | 2011-10-25 | PO BOX 1312, MULBERRY, FL, 338601312, US | 708 N CHURCH AVE, MULBERRY, FL, 338602034, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 863-604-2235 |
| Fax | 8636468575 |
| Phone | +1 863-425-9309 |
| Fax | 8634258401 |
Authorized person
| Name | MRS. PATRICIA G SALAZAR |
| Role | OWNER - PRESIDENT |
| Phone | 8636042235 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AETNA |
| Number | 2524166 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | CH9637 |
| State | FL |
| Issuer | BLUE SHIELD FL |
| Number | 45760 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SALAZAR PATRICIA G | Agent | 1310 N. CHURCH AVE, MULBERRY, FL, 33860 |
| Name | Role | Address |
|---|---|---|
| SALAZAR PATRICIA G | President | 1310 NORTH CHURCH AVENUE, MULBERRY, FL, 33860 |
| Name | Role | Address |
|---|---|---|
| SALAZAR PATRICIA G | Secretary | 1310 NORTH CHURCH AVENUE, MULBERRY, FL, 33860 |
| Name | Role | Address |
|---|---|---|
| SALAZAR PATRICIA G | Director | 1310 NORTH CHURCH AVENUE, MULBERRY, FL, 33860 |
| GALBIS ELENA | Director | 2117 BRISTOL AVE, LAKELAND, FL, 33802 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-01-16 | 1310 N. CHURCH AVE, MULBERRY, FL 33860 | No data |
| CHANGE OF MAILING ADDRESS | 2003-01-16 | 1310 N. CHURCH AVE, MULBERRY, FL 33860 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-01-16 | SALAZAR, PATRICIA G | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-01-16 | 1310 N. CHURCH AVE, MULBERRY, FL 33860 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-04-20 |
| ANNUAL REPORT | 2008-03-13 |
| ANNUAL REPORT | 2007-08-14 |
| ANNUAL REPORT | 2006-02-10 |
| ANNUAL REPORT | 2005-07-28 |
| ANNUAL REPORT | 2004-03-29 |
| ANNUAL REPORT | 2003-01-16 |
| ANNUAL REPORT | 2002-03-04 |
| Domestic Profit | 2000-12-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
