| Entity Name: | NORMA ROCHE,MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Apr 2004 (21 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 07 Nov 2007 (17 years ago) |
| Document Number: | P04000062903 |
| FEI/EIN Number | 900253540 |
| Address: | 698 N HOMESTEAD BLVD, STE 104, HOMESTEAD, FL, 33030, US |
| Mail Address: | 698 N HOMESTEAD BLVD, STE 104, HOMESTEAD, FL, 33030, US |
| ZIP code: | 33030 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124368535 | 2013-02-21 | 2017-01-04 | 698 N HOMESTEAD BLVD STE 104, HOMESTEAD, FL, 330306208, US | 698 N HOMESTEAD BLVD STE 104, HOMESTEAD, FL, 330306208, US | |||||||||||||||||||||||||
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| Phone | +1 305-245-3534 |
| Fax | 3052453563 |
Authorized person
| Name | NORMA ROCHE |
| Role | PHYSICIAN |
| Phone | 3052453534 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME87339 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA BLUE |
| Number | FRZGX |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NORMA ROCHE MD | Agent | 698 N. HOMESTEAD BLVD, HOMESTEAD, FL, 33030 |
| Name | Role | Address |
|---|---|---|
| ROCHE NORMA M | President | 698 NORTH HOMESTEAD BLVD., SUITE 104, HOMESTEAD, FL, 33030 |
| Name | Role | Address |
|---|---|---|
| ROCHE NORMA M | Secretary | 698 NORTH HOMESTEAD BLVD., SUITE 104, HOMESTEAD, FL, 33030 |
| Name | Role | Address |
|---|---|---|
| ROCHE NORMA M | Director | 698 NORTH HOMESTEAD BLVD., SUITE 104, HOMESTEAD, FL, 33030 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2009-04-14 | NORMA ROCHE MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-14 | 698 N. HOMESTEAD BLVD, SUITE 104, HOMESTEAD, FL 33030 | No data |
| CANCEL ADM DISS/REV | 2007-11-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-09 | 698 N HOMESTEAD BLVD, STE 104, HOMESTEAD, FL 33030 | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-09 | 698 N HOMESTEAD BLVD, STE 104, HOMESTEAD, FL 33030 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-03-30 |
| ANNUAL REPORT | 2016-02-23 |
| ANNUAL REPORT | 2015-01-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
