| Entity Name: | JOSEPH A. RODRIGUEZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Aug 2002 (22 years ago) |
| Date of dissolution: | 01 May 2024 (9 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 01 May 2024 (9 months ago) |
| Document Number: | P02000091070 |
| FEI/EIN Number | 680519070 |
| Address: | 4611 S. UNIVERSITY DRIVE, DAVIE, FL, 33328 |
| Mail Address: | 4611 S. UNIVERSITY DRIVE, DAVIE, FL, 33328, US |
| ZIP code: | 33328 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932410222 | 2010-07-01 | 2013-11-08 | 4611 S UNIVERSITY DR, DAVIE, FL, 333283817, US | 2216 HOLLYWOOD BLVD, HOLLYWOOD, FL, 330206702, US | |||||||||||||||||||||||||
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| Phone | +1 954-610-7739 |
| Fax | 9549262956 |
Authorized person
| Name | DR. JOSEPH ANTHONY RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 9546107739 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0058775 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00861300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ JOSEPH A | Agent | 4611 SOUTH UNIVERSITY DRIVE, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ JOSEPH A | President | 4611 SOUTH UNIVERSITY DRIVE, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ JOSEPH A | Vice President | 4611 SOUTH UNIVERSITY DRIVE, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ JOSEPH A | Secretary | 4611 SOUTH UNIVERSITY DRIVE, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ JOSEPH A | Treasurer | 4611 SOUTH UNIVERSITY DRIVE, DAVIE, FL, 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-05-01 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-28 | 4611 S. UNIVERSITY DRIVE, DAVIE, FL 33328 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-05-22 | 4611 S. UNIVERSITY DRIVE, DAVIE, FL 33328 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-05-22 | RODRIGUEZ, JOSEPH A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-05-22 | 4611 SOUTH UNIVERSITY DRIVE, DAVIE, FL 33328 | No data |
| NAME CHANGE AMENDMENT | 2004-05-14 | JOSEPH A. RODRIGUEZ, M.D., P.A. | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-05-01 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
