| Entity Name: | SANTANA DIAGNOSTIC SERVICES CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Jun 2003 (22 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P03000066507 |
| FEI/EIN Number | 010787739 |
| Address: | 12855 SW 136 AVE, STE 212, MIAMI, FL, 33186 |
| Mail Address: | 12855 SW 136 AVE, STE 212, MIAMI, FL, 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144219874 | 2005-10-15 | 2020-08-22 | 12855 SW 136TH AVE, SUITE 212, MIAMI, FL, 331865885, US | 12855 SW 136TH AVE, SUITE 212, MIAMI, FL, 331865885, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-251-4449 |
Authorized person
| Name | DR. MANUEL R DEL VALLE |
| Role | PRESIDENT |
| Phone | 3052514449 |
Taxonomy
| Taxonomy Code | 246XS1301X - Sonography Specialist/Technologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | U1632 |
| State | FL |
| Issuer | ACHA LICENSE |
| Number | HCC4137 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DEL VALLE MANUEL R | Agent | 12855 SW 136 AVE, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE MANUEL M | Secretary | 12855 SW 136 AVE # 212, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE EUSEBIO | Director | 12855 SW 136 AVE # 212, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE MANUEL R | President | 12855 SW 136 AVE # 212, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2010-10-02 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| AMENDMENT | 2005-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-05-04 | 12855 SW 136 AVE, STE 212, MIAMI, FL 33186 | No data |
| CHANGE OF MAILING ADDRESS | 2004-05-04 | 12855 SW 136 AVE, STE 212, MIAMI, FL 33186 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-05-04 | DEL VALLE, MANUEL R | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-05-04 | 12855 SW 136 AVE, STE 212, MIAMI, FL 33186 | No data |
| AMENDMENT | 2004-02-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-30 |
| REINSTATEMENT | 2010-10-02 |
| ANNUAL REPORT | 2009-05-14 |
| ANNUAL REPORT | 2008-04-29 |
| ANNUAL REPORT | 2007-05-02 |
| ANNUAL REPORT | 2006-05-01 |
| Amendment | 2005-09-27 |
| ANNUAL REPORT | 2005-05-03 |
| ANNUAL REPORT | 2004-05-04 |
| Amendment | 2004-02-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
