| Entity Name: | GLEZ AND GLEZ S-CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Aug 2002 (23 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 16 Aug 2019 (5 years ago) |
| Document Number: | P02000083840 |
| FEI/EIN Number | 331016336 |
| Address: | 3804 NW 167 ST., MIAMI GARDENS, FL, 33054-6332, US |
| Mail Address: | 3804 NW 167 ST., MIAMI GARDENS, FL, 33054-6332, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205937034 | 2006-09-26 | 2014-06-11 | 3804 NW 167TH ST, OPA LOCKA, FL, 330546232, US | 3804 NW 167TH ST, OPA LOCKA, FL, 330546232, US | |||||||||||||||||||||
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| Phone | +1 305-624-2700 |
| Fax | 3056243154 |
Authorized person
| Name | RAFAEL D GONZALEZ |
| Role | ADMINISTRATOR |
| Phone | 3056242700 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 266322800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ RAFAEL D | Agent | 3804 NW 167TH STREET, MIAMI GARDENS, FL, 330546332 |
| Name | Role | Address |
|---|---|---|
| GLEZ RAFAEL | President | 3804 NW 167 ST., MIAMI GARDENS, FL, 330546332 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ RAFAEL D | Vice President | 3804 NW 167 ST., MIAMI GARDENS, FL, 330546332 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G07255900247 | GLEZ & GLEZ MEDICAL CENTER | ACTIVE | 2007-09-12 | 2027-12-31 | No data | 3804 NW 167 STREET, MIAMI GARDENS, FL, 33054 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2019-08-16 | No data | No data |
| REINSTATEMENT | 2011-12-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-15 | 3804 NW 167TH STREET, MIAMI GARDENS, FL 33054-6332 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-15 | 3804 NW 167 ST., MIAMI GARDENS, FL 33054-6332 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-15 | 3804 NW 167 ST., MIAMI GARDENS, FL 33054-6332 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-03-18 | GONZALEZ, RAFAEL D | No data |
| CANCEL ADM DISS/REV | 2006-10-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| AMENDMENT | 2006-03-29 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| AMENDED ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-20 |
| Amendment | 2019-08-16 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
