| Entity Name: | PROVIDENCE MEDICAL CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Mar 2001 (24 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 May 2022 (3 years ago) |
| Document Number: | P01000023601 |
| FEI/EIN Number | 651084702 |
| Address: | 2500 SW 107 Ave, Miami, FL, 33165, US |
| Mail Address: | 13111 SW 82 Terrace, MIAMI, FL, 33183, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053320382 | 2006-08-05 | 2007-08-23 | 10348 W FLAGLER ST, MIAMI, FL, 331741746, US | 10348 W FLAGLER ST, MIAMI, FL, 331741746, US | |||||||||||||||
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| Phone | +1 305-220-8006 |
| Fax | 3052205002 |
Authorized person
| Name | FRANCISCO D GUERRA-MORALES |
| Role | DIRECTOR |
| Phone | 3052208006 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| QUINTANA FRANCISCO | Agent | 2500 SW 107 Ave, Miami, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| QUINTANA FRANCISCO X | President | 13111 SW 82ND TERRACE, MIAMI, FL, 33183 |
| Name | Role | Address |
|---|---|---|
| MARENCO ANGELA P | Vice President | 13111 SW 82 TERRACE, MIAMI, FL, 33183 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-05-03 | QUINTANA, FRANCISCO | No data |
| CHANGE OF MAILING ADDRESS | 2022-05-03 | 2500 SW 107 Ave, Suite 29, Miami, FL 33165 | No data |
| REINSTATEMENT | 2022-05-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-10-26 | 2500 SW 107 Ave, Suite 29, Miami, FL 33165 | No data |
| AMENDMENT | 2020-10-26 | No data | No data |
| AMENDMENT | 2017-12-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-16 | 2500 SW 107 Ave, Suite 29, Miami, FL 33165 | No data |
| REINSTATEMENT | 2012-11-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-10 |
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-03-24 |
| REINSTATEMENT | 2022-05-03 |
| Amendment | 2020-10-26 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-03-02 |
| Amendment | 2017-12-14 |
| ANNUAL REPORT | 2017-01-16 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 9689298105 | 2020-07-29 | 0455 | PPP | 2500 SW 107TH AVE STE 29, MIAMI, FL, 33165 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
