| Entity Name: | CARLOS A. CONRADO, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Sep 2002 (22 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P02000095974 |
| FEI/EIN Number | 020641501 |
| Address: | 151 N.W. 11 ST., E102, HOMESTEAD, FL, 33030 |
| Mail Address: | 151 N.W. 11 ST., E102, HOMESTEAD, FL, 33030 |
| ZIP code: | 33030 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912023631 | 2007-03-22 | 2012-06-11 | 151 NW 11TH ST, SUITE E102, HOMESTEAD, FL, 330304360, US | 151 NW 11TH ST, SUITE E102, HOMESTEAD, FL, 330304360, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-248-4877 |
| Fax | 3052451576 |
Authorized person
| Name | DR. CARLOS A CONRADO |
| Role | OWNER |
| Phone | 3052484877 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 0061233 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 267644300 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 18453 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CONRADO CARLOS A | Agent | 151 N.W. 11 ST., HOMESTEAD, FL, 33030 |
| Name | Role | Address |
|---|---|---|
| CONRADO CARLOS A | President | 151 N.W. 11 ST., HOMESTEAD, FL, 33030 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-03-27 | CONRADO, CARLOS A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-03-27 | 151 N.W. 11 ST., E102, HOMESTEAD, FL 33030 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-16 | 151 N.W. 11 ST., E102, HOMESTEAD, FL 33030 | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-16 | 151 N.W. 11 ST., E102, HOMESTEAD, FL 33030 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-01-20 |
| ANNUAL REPORT | 2013-03-27 |
| ANNUAL REPORT | 2012-03-06 |
| ANNUAL REPORT | 2011-03-10 |
| ANNUAL REPORT | 2010-01-19 |
| ANNUAL REPORT | 2009-01-16 |
| ANNUAL REPORT | 2008-01-23 |
| ANNUAL REPORT | 2007-03-12 |
| ANNUAL REPORT | 2006-01-16 |
| ANNUAL REPORT | 2005-02-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
