| Entity Name: | HERNANDEZ PROFESSIONAL MEDICAL SERVICES CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Jan 2003 (22 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P03000009508 |
| FEI/EIN Number | 061680895 |
| Address: | 5511 S.W. 8TH ST., # 101, MIAMI, FL, 33134 |
| Mail Address: | 15649 SW 60 ST., MIAMI, FL, 33193 |
| ZIP code: | 33134 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528091626 | 2006-07-09 | 2008-06-19 | 7824 SW 195TH TER, CUTLER BAY, FL, 331578130, US | 1835 W FLAGLER ST, SUITE 4, MIAMI, FL, 331351917, US | |||||||||||||||||||||
|
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| Phone | +1 305-541-4004 |
| Fax | 3056444988 |
Authorized person
| Name | DR. MIGUEL F HERNANDEZ |
| Role | PHYSICIAN |
| Phone | 3055414004 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 259453600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ MIGUEL M | Agent | 15649 S.W. 60 ST., MIAMI, FL, 33193 |
| Name | Role | Address |
|---|---|---|
| MONTOYA KARLA | President | 15649 SW 60 ST., MIAMI, FL, 33193 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ MIGUEL M | Vice President | 15649 SW 60 ST., MIAMI, FL, 33193 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2006-07-26 | HERNANDEZ, MIGUEL M.D. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-07-26 | 5511 S.W. 8TH ST., # 101, MIAMI, FL 33134 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-07-12 | 15649 S.W. 60 ST., MIAMI, FL 33193 | No data |
| CANCEL ADM DISS/REV | 2005-07-12 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2005-07-12 | 5511 S.W. 8TH ST., # 101, MIAMI, FL 33134 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| AMENDMENT | 2003-09-23 | No data | No data |
| AMENDMENT | 2003-02-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-01-28 |
| ANNUAL REPORT | 2007-01-08 |
| ANNUAL REPORT | 2006-07-26 |
| REINSTATEMENT | 2005-07-12 |
| Amendment | 2003-09-23 |
| Amendment | 2003-02-07 |
| Domestic Profit | 2003-01-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
