| Entity Name: | PATAKY MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Jul 2002 (23 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P02000075523 |
| FEI/EIN Number | 562283674 |
| Address: | 12781 SW 42 STREET, MIAMI, FL, 33175, US |
| Mail Address: | 12781 SW 42 STREET, MIAMI, FL, 33175, US |
| ZIP code: | 33175 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114988151 | 2006-03-29 | 2016-02-16 | 12781 SW 42ND ST, SUITE G, MIAMI, FL, 331753437, US | 12781 SW 42ND ST, SUITE G, MIAMI, FL, 331753437, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-553-2220 |
| Fax | 3055539753 |
Authorized person
| Name | CARMEN ZILIA OLIVA |
| Role | PRESIDENT |
| Phone | 3055532220 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | HCC10449 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | HCC10449 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PTAN |
| Number | K8416A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ ORLANDO | Agent | 12781 SW 42 STREET, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| Rodriguez Orlando | President | 12781 SW 42 St, Miami, FL, 33175 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-30 | RODRIGUEZ, ORLANDO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-19 | 12781 SW 42 STREET, Suite G, MIAMI, FL 33175 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-19 | 12781 SW 42 STREET, Suite G, MIAMI, FL 33175 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-19 | 12781 SW 42 STREET, Suite G, MIAMI, FL 33175 | No data |
| AMENDMENT | 2015-09-28 | No data | No data |
| AMENDMENT | 2015-06-19 | No data | No data |
| AMENDMENT | 2005-05-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-04-19 |
| Amendment | 2015-06-19 |
| ANNUAL REPORT | 2015-03-31 |
| ANNUAL REPORT | 2014-03-23 |
| ANNUAL REPORT | 2013-02-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
