| Entity Name: | CYBERMED DIAGNOSTIC LAB, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Mar 2002 (23 years ago) |
| Document Number: | P02000030590 |
| FEI/EIN Number | 043626842 |
| Address: | 14871 SW 160 STREET, MIAMI, FL, 33187 |
| Mail Address: | 14871 SW 160 STREET, MIAMI, FL, 33187 |
| ZIP code: | 33187 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821081100 | 2005-08-23 | 2020-08-22 | 9380 SW 72ND ST, MIAMI, FL, 331733244, US | 9380 SW 72ND ST, MIAMI, FL, 331733276, US | |||||||||||||||||||
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| Phone | +1 305-598-1864 |
| Fax | 3055981874 |
Authorized person
| Name | MR. HUMBERTO BORQUE |
| Role | PRESIDENT CEO |
| Phone | 3053001641 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC6120 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BORQUE HUMBERTO | Agent | 9380 SW 72 STREET, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| BORQUE HUMBERTO | Chief Executive Officer | 9380 SW 72 STREET SUITE B-212, MIAMI, FL, 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CANCEL ADM DISS/REV | 2004-07-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
