| Entity Name: | PANAMERICAN HEALTH CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Nov 2003 (21 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 16 Apr 2009 (16 years ago) |
| Document Number: | P03000127575 |
| FEI/EIN Number | 113707339 |
| Address: | 4750 NW 7TH ST., # 13, MIAMI, FL, 33126 |
| Mail Address: | 4750 NW 7TH ST., # 13, MIAMI, FL, 33126 |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1598923450 | 2008-05-28 | 2019-12-10 | 4750 NW 7TH STREET, SUITE 13, MIAMI, FL, 331262253, US | 4750 NW 7TH STREET, SUITE 13, MIAMI, FL, 331262253, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-567-0060 |
| Fax | 3055670065 |
Authorized person
| Name | MR. CARLOS A RIVERO |
| Role | AUTHORIZED OFFICIAL |
| Phone | 3055670060 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8930 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | HCC6049 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ACN 223 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ACN 316 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2355S0801X - Speech-Language Assistant |
| License Number | SI 637 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| License Number | CI 415 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | K8291A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RIVERO CARLOS A | Agent | 4750 NW 7 ST, MIAMI, FL, 33126 |
| Name | Role | Address |
|---|---|---|
| RIVERO CARLOS A | President | 4750 NW 7 ST # 13, MIAMI, FL, 33126 |
| Name | Role | Address |
|---|---|---|
| RIVERO CARLOS A | Director | 4750 NW 7 ST # 13, MIAMI, FL, 33126 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2009-04-16 | PANAMERICAN HEALTH CENTER, INC | No data |
| AMENDMENT | 2006-02-28 | No data | No data |
| AMENDMENT | 2005-06-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-09-10 | 4750 NW 7 ST, # 13, MIAMI, FL 33126 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-09-10 | 4750 NW 7TH ST., # 13, MIAMI, FL 33126 | No data |
| CHANGE OF MAILING ADDRESS | 2004-09-10 | 4750 NW 7TH ST., # 13, MIAMI, FL 33126 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-09-10 | RIVERO, CARLOS A | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-01-16 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-02-15 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-04-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
