| Entity Name: | EDGARDO CRUZ-MARTINEZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Oct 2003 (21 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: | P03000126041 |
| FEI/EIN Number | 562413078 |
| Address: | 4600 SW 46TH CT, STE 120, OCALA, FL, 34474 |
| Mail Address: | 4600 SW 46TH CT, STE 120, OCALA, FL, 34474 |
| ZIP code: | 34474 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326239161 | 2007-08-07 | 2007-08-07 | 4600 SW 46TH CT STE 120, OCALA, FL, 344745785, US | 4600 SW 46TH CT STE 120, OCALA, FL, 344745785, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-861-5225 |
| Fax | 3528615226 |
Authorized person
| Name | EDGARDO CRUZ-MARTINEZ |
| Role | M.D. |
| Phone | 3528615225 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME78169 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AVMED |
| Number | 274278 |
| State | FL |
| Issuer | BCBS |
| Number | 35563 |
| State | FL |
| Issuer | CIGNA |
| Number | 3016994 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CRUZ-MARTINEZ EDGARDO | Agent | 4600 SW 46TH CT, OCALA, FL, 34474 |
| Name | Role | Address |
|---|---|---|
| CRUZ-MARTINEZ EDGARDO | Manager | 4600 SW 46TH CT, STE 120, OCALA, FL, 34474 |
| Name | Role | Address |
|---|---|---|
| CRUZ-MARTINEZ EDGARDO | Director | 4600 SW 46TH CT, STE 120, OCALA, FL, 34474 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-07-01 | 4600 SW 46TH CT, STE 120, OCALA, FL 34474 | No data |
| CHANGE OF MAILING ADDRESS | 2005-07-01 | 4600 SW 46TH CT, STE 120, OCALA, FL 34474 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-07-01 | 4600 SW 46TH CT, STE # 120, OCALA, FL 34474 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-04-12 | CRUZ-MARTINEZ, EDGARDO | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-03-27 |
| ANNUAL REPORT | 2007-04-09 |
| ANNUAL REPORT | 2006-05-01 |
| ANNUAL REPORT | 2005-07-01 |
| ANNUAL REPORT | 2004-04-12 |
| Domestic Profit | 2003-10-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
