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PRESTAB CO.

Company Details

Entity Name: PRESTAB CO.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 13 Nov 2002 (22 years ago)
Document Number: P02000121139
FEI/EIN Number 200124049
Mail Address: P.O.BOX 831225, MIAMI, FL, 33283
Address: 29943 SOUTH DIXIE HIGHWAY, HOMESTEAD, FL, 33033
ZIP code: 33033
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1730261033 2006-10-19 2020-08-22 3016 NW 79TH AVE, DORAL, FL, 331221010, US 3016 NW 79TH AVE, DORAL, FL, 331221010, US

Contacts

Phone +1 305-599-1643
Fax 3055991663

Authorized person

Name MRS. ALEXIS M. BASULTO
Role PRESIDENT
Phone 3055997000

Taxonomy

Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number PH19462
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 02697010
State FL

Agent

Name Role Address
GIZ ADELFO Agent 29943 SOUTH DIXIE HIGHWAY, HOMESTEAD, FL, 33033

President

Name Role Address
GIZ ADELFO President P.O.BOX 831225, MIAMI, FL, 33283

Vice Treasurer

Name Role Address
GIZ ADELFO Vice Treasurer P.O.BOX 831225, MIAMI, FL, 33283

Director

Name Role Address
GIZ ADELFO Director P.O.BOX 831225, MIAMI, FL, 33283

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 No data No data
REINSTATEMENT 2014-02-26 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 No data No data
REINSTATEMENT 2011-08-11 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data
AMENDMENT 2007-03-23 No data No data
AMENDMENT 2004-08-09 No data No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J12000252786 LAPSED 1000000260274 DADE 2012-03-22 2022-04-06 $ 573.23 STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SOUTH SERVICE CENTER, 8175 NW 12TH ST STE 418, DORAL FL331261828
J11000057880 LAPSED 08-4861CA 06 MIAMI-DADE CIRCUIT COURT 2010-12-02 2016-02-01 $19,691.55 AMERISOURCEBERGEN DRUG CORP, F/K/A AMERISURE CORP., 2100 DIRECTORS ROW, ORLANDO, FL, 32809

Date of last update: 03 Jan 2025

Sources: Florida Department of State