| Entity Name: | NEW LIFE POLYCLINICS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Mar 2004 (21 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P04000043113 |
| FEI/EIN Number | 20-0844131 |
| Address: | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| Mail Address: | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386700912 | 2006-12-28 | 2008-08-19 | 61 HOOK SQ, MIAMI SPRINGS, FL, 331664401, US | 61 HOOK SQ, MIAMI SPRINGS, FL, 331664401, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 305-884-8880 |
| Fax | 3058847740 |
Authorized person
| Name | MRS. MARIA TERESA COLUMBIE |
| Role | PRESIDENT |
| Phone | 3058848880 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | HCC7720 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 305S00000X - Point of Service |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 277418600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ-PAUSA, WALDA M | Agent | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ-PAUSA, WALDA M | RA | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ-PAUSA, WALDA M | President | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| Name | Role | Address |
|---|---|---|
| PEREZ, MAGDIEL, Sr. | Vice President | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| Name | Role | Address |
|---|---|---|
| PEREZ, VERONICA D | Secretary | 61 HOOK SQUARE, MIAMI SPRING, FL 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2009-10-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-10-19 | VAZQUEZ-PAUSA, WALDA M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| REINSTATEMENT | 2006-03-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000842855 | LAPSED | 1000000616658 | MIAMI-DADE | 2014-05-09 | 2024-08-01 | $ 954.13 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J13001448506 | TERMINATED | 1000000512543 | MIAMI-DADE | 2013-09-16 | 2023-10-03 | $ 1,041.46 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J13000095423 | TERMINATED | 1000000327253 | MIAMI-DADE | 2012-12-20 | 2023-01-16 | $ 2,152.25 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-27 |
| ANNUAL REPORT | 2011-03-02 |
| ANNUAL REPORT | 2010-03-31 |
| REINSTATEMENT | 2009-10-19 |
| ANNUAL REPORT | 2008-08-24 |
| ANNUAL REPORT | 2007-11-29 |
| ANNUAL REPORT | 2007-05-07 |
| REINSTATEMENT | 2006-03-07 |
| Off/Dir Resignation | 2005-07-01 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
