| Entity Name: | COMPLETE BIO SOLUTIONS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Jul 2001 (24 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P01000073159 |
| FEI/EIN Number | 651125508 |
| Address: | 6500 NW 77 CT, MIAMI, FL, 33166, US |
| Mail Address: | 6500 NW 77 CT, MIAMI, FL, 33166, US |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023179736 | 2006-12-13 | 2019-05-06 | 6500 NW 77TH CT, MIAMI, FL, 331662710, US | 6500 NW 77TH CT, MIAMI, FL, 331662710, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 305-882-1051 |
| Fax | 3058821052 |
Authorized person
| Name | HERIBERTO ERNESTO MARTINEZ |
| Role | PRESIDENT |
| Phone | 3058821051 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800016693 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 030716500 |
| State | FL |
| Issuer | CLIA |
| Number | 800016693 |
| State | FL |
| Issuer | BLUECROSS BLUESHIELD |
| Number | L9248 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARTINEZ HERIBERTO E | Agent | 6500 NW 77 CT, MIAMI, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ HERIBERTO E | PDTE | 6500 NW 77 CT, MIAMI, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| MORALES ALEXANDER | Secretary | 6500 NW 77 CT, MIAMI, FL, 33166 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000055436 | CBS RENAL LABS | EXPIRED | 2019-05-07 | 2024-12-31 | No data | 6500 NW 77 COURT, MIAMI, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-23 | 6500 NW 77 CT, MIAMI, FL 33166 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-23 | 6500 NW 77 CT, MIAMI, FL 33166 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-23 | 6500 NW 77 CT, MIAMI, FL 33166 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-01-29 | MARTINEZ, HERIBERTO E | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-01-21 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-04-27 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-04-28 |
| ANNUAL REPORT | 2011-04-30 |
| ANNUAL REPORT | 2010-04-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
