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JUAN A. MANTILLA, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: JUAN A. MANTILLA, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 04 Nov 2002 (23 years ago)
Document Number: P02000118834
FEI/EIN Number 043721515
Address: 11400 N. Kendall drive, SUITE 204, MIAMI, FL, 33176, US
Mail Address: 11400 N. Kendall drive, SUITE 204, MIAMI, FL, 33176, US
ZIP code: 33176
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
MANTILLA JUAN A Director 7259 SW 120 court, Miami, FL, 33183
MANTILLA JUAN A President 7259 SW 120 court, Miami, FL, 33183
MANTILLA JUAN A Secretary 7259 SW 120 court, Miami, FL, 33183
MANTILLA JUAN A Treasurer 7259 SW 120 court, Miami, FL, 33183
BAIRD STEVEN K Agent 5981 NE SIXTH AVENUE, MIAMI, FL, 33137

National Provider Identifier

NPI Number:
1962732388
Certification Date:
2021-06-29

Authorized Person:

Name:
DR. JUAN ALBERTO MANTILLA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3055012031

Form 5500 Series

Employer Identification Number (EIN):
043721515
Plan Year:
2018
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
3
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2020-03-19 11400 N. Kendall drive, SUITE 204, MIAMI, FL 33176 -
CHANGE OF MAILING ADDRESS 2020-03-19 11400 N. Kendall drive, SUITE 204, MIAMI, FL 33176 -
REGISTERED AGENT ADDRESS CHANGED 2005-01-31 5981 NE SIXTH AVENUE, MIAMI, FL 33137 -

Documents

Name Date
ANNUAL REPORT 2024-03-18
ANNUAL REPORT 2023-03-29
ANNUAL REPORT 2022-06-09
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-03-19
ANNUAL REPORT 2019-05-13
ANNUAL REPORT 2018-04-05
ANNUAL REPORT 2017-03-31
ANNUAL REPORT 2016-03-06
ANNUAL REPORT 2015-02-23

USAspending Awards / Financial Assistance

Date:
2020-04-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
126762.00
Total Face Value Of Loan:
126762.00

Paycheck Protection Program

Jobs Reported:
11
Initial Approval Amount:
$126,762
Date Approved:
2020-04-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$126,762
Race:
Unanswered
Ethnicity:
Hispanic or Latino
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$127,487.36
Servicing Lender:
Dade County FCU
Use of Proceeds:
Payroll: $95,072
Utilities: $6,890
Rent: $24,800

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Date of last update: 02 Jul 2025

Sources: Florida Department of State