| Entity Name: | NOVALES MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Oct 2003 (21 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P03000111619 |
| FEI/EIN Number | 020708584 |
| Address: | 470 NW 22 AVENUE, MIAMI, FL, 33125 |
| Mail Address: | 470 NW 22 AVENUE, MIAMI, FL, 33125 |
| ZIP code: | 33125 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306822440 | 2005-12-20 | 2010-01-08 | 470 NW 22ND AVE, MIAMI, FL, 331253352, US | 470 NW 22ND AVE, MIAMI, FL, 331253352, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-643-4684 |
| Fax | 3056434680 |
Authorized person
| Name | MS. OLGA RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 3056434684 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME 70533 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | ME 59048 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | ME 55079 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 273175400 |
| State | FL |
| Issuer | HUMANA |
| Number | 170540 |
| State | FL |
| Issuer | BLUECROSS BLUESHIELD OF F |
| Number | 94970 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| REY FRANCISCO J | Agent | 470 NW 22 AVENUE, MIAMI, FL, 33125 |
| Name | Role | Address |
|---|---|---|
| REY FRANCISCO J | Director | 470 NW 22 AVENUE, MIAMI, FL, 33125 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| AMENDMENT | 2009-05-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-05-15 | REY, FRANCISCO J | No data |
| REINSTATEMENT | 2005-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| Amendment | 2009-05-15 |
| ANNUAL REPORT | 2009-02-10 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-07-25 |
| ANNUAL REPORT | 2006-01-18 |
| REINSTATEMENT | 2005-10-18 |
| ANNUAL REPORT | 2004-02-02 |
| Domestic Profit | 2003-10-09 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
