| Entity Name: | EDGARDO R. REYES-AYALA, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Mar 2001 (24 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Oct 2013 (11 years ago) |
| Document Number: | P01000030901 |
| FEI/EIN Number | 651092589 |
| Address: | 5000 UNIVERSITY DRIVE,, CORAL GABLES, FL, 33146, US |
| Mail Address: | 5000 UNIVERSITY DRIVE,, CORAL GABLES, FL, 33146, US |
| ZIP code: | 33146 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649365883 | 2006-10-04 | 2023-10-23 | 5000 UNIVERSITY DR STE 1100, CORAL GABLES, FL, 331462008, US | 5000 UNIVERSITY DR STE 1100, CORAL GABLES, FL, 331462008, US | |||||||||||||||||||||||||
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| Phone | +1 305-663-0088 |
| Fax | 3056631933 |
Authorized person
| Name | DR. EDGARDO R REYES-AYALA |
| Role | PHYSICIAN |
| Phone | 3056630088 |
Taxonomy
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| License Number | ME74498 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 254669800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| REYES-AYALA EDGARDO R | Agent | 5000 University Drive, Coral Gables, FL, 33146 |
| Name | Role | Address |
|---|---|---|
| REYES-AYALA EDGARDO R | President | 5000 University Drive, Coral Gables, FL, 33146 |
| Name | Role | Address |
|---|---|---|
| REYES-AYALA EDGARDO R | Director | 5000 University Drive, Coral Gables, FL, 33146 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-02 | 5000 University Drive, Suite 1100, Coral Gables, FL 33146 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-23 | 5000 UNIVERSITY DRIVE,, SUITE 1100, CORAL GABLES, FL 33146 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-23 | 5000 UNIVERSITY DRIVE,, SUITE 1100, CORAL GABLES, FL 33146 | No data |
| REINSTATEMENT | 2013-10-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CANCEL ADM DISS/REV | 2009-02-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2006-05-25 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2023-04-19 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-03-09 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-02-05 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-05-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
