| Entity Name: | PEDRO L. ORTEGA MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 20 Jul 2001 (24 years ago) |
| Date of dissolution: | 30 Oct 2020 (4 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 30 Oct 2020 (4 years ago) |
| Document Number: | P01000071744 |
| FEI/EIN Number | 59-3726972 |
| Address: | 3727 NORTH GOLDENROD ROAD, SUITE 106, WINTER PARK, FL 32792 |
| Mail Address: | 3727 NORTH GOLDENROD ROAD, SUITE 106, WINTER PARK, FL 32792 |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326438771 | 2015-01-23 | 2015-01-23 | 3727 N GOLDENROD RD, SUITE 106, WINTER PARK, FL, 327928611, US | 3727 N GOLDENROD RD, SUITE 106, WINTER PARK, FL, 327928611, US | |||||||||||||||||||||||||
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| Phone | +1 407-478-0028 |
| Fax | 4074760297 |
Authorized person
| Name | DR. PEDRO L ORTEGA |
| Role | PHYSICIAN/OWNER |
| Phone | 4074780028 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME0075974 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009320800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ORTEGA, PEDRO LMD | Agent | 3727 NORTH GOLDENROD ROAD, SUITE 106, WINTER PARK, FL 32792 |
| Name | Role | Address |
|---|---|---|
| ORTEGA, PEDRO L | DR. | 3727 NORTH GOLDENROD ROAD, SUITE 106 WINTER PARK, FL 32792 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2020-10-30 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L20000347031. CONVERSION NUMBER 500000207145 |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-24 | 3727 NORTH GOLDENROD ROAD, SUITE 106, WINTER PARK, FL 32792 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-30 | 3727 NORTH GOLDENROD ROAD, SUITE 106, WINTER PARK, FL 32792 | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-30 | 3727 NORTH GOLDENROD ROAD, SUITE 106, WINTER PARK, FL 32792 | No data |
| REGISTERED AGENT NAME CHANGED | 2002-05-29 | ORTEGA, PEDRO LMD | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000853599 | TERMINATED | 1000000459854 | LEON | 2013-04-24 | 2033-05-03 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-02-24 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-03-07 |
| ANNUAL REPORT | 2016-01-18 |
| ANNUAL REPORT | 2015-03-19 |
| ANNUAL REPORT | 2014-01-20 |
| ANNUAL REPORT | 2013-02-26 |
| ANNUAL REPORT | 2012-02-13 |
| ANNUAL REPORT | 2011-04-27 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
