| Entity Name: | ROMULO CLAVELO, M.D.P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 May 2002 (23 years ago) |
| Document Number: | P02000047944 |
| FEI/EIN Number | 043655864 |
| Address: | 1325 sw 1 st, MIAMI, FL, 33135, US |
| Mail Address: | 5845 Collins Ave, apt 102, Miami Beach, FL, 33140, US |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083847727 | 2009-08-28 | 2010-07-06 | PO BOX 402054, MIAMI BEACH, FL, 331400054, US | 78 SW 13TH AVE, SUITE 201, MIAMI, FL, 331352479, US | |||||||||||||||||||||||
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| Phone | +1 305-631-0470 |
Authorized person
| Name | ROMULO CLAVELO |
| Role | PRESIDENT |
| Phone | 7865435581 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME90231 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 266250700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CLAVELO ROMULO | Agent | 1325 sw 1 st, MIAMI, FL, 33135 |
| Name | Role | Address |
|---|---|---|
| CLAVELO ROMULO | Director | 1325 sw 1 st, MIAMI, FL, 33135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-01-30 | 1325 sw 1 st, MIAMI, FL 33135 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-24 | 1325 sw 1 st, MIAMI, FL 33135 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-24 | 1325 sw 1 st, MIAMI, FL 33135 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-31 |
| ANNUAL REPORT | 2017-01-28 |
| ANNUAL REPORT | 2016-02-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
