| Entity Name: | POLICLINICO PASTORITA INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Jun 2004 (21 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P04000089386 |
| FEI/EIN Number | 562465037 |
| Address: | 450 SW 8TH STREET, MIAMI, FL, 33130 |
| Mail Address: | 450 SW 8TH STREET, MIAMI, FL, 33130 |
| ZIP code: | 33130 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891746525 | 2006-05-15 | 2011-02-09 | 450 SW 8TH ST, MIAMI, FL, 331302814, US | 450 SW 8TH ST, MIAMI, FL, 331302814, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-860-0044 |
| Fax | 3058600171 |
Authorized person
| Name | LAZARA M SANCHEZ |
| Role | ADMINISTRATOR |
| Phone | 3058600044 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME49132 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 94846 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ MAY MIGUEL I | Agent | 450 SW 8TH STREET, MIAMI, FL, 33130 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ MAY MIGUEL I | President | 450 SW 8TH STREET, MIAMI, FL, 33130 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2011-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| AMENDMENT | 2011-03-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-16 | RODRIGUEZ MAY, MIGUEL I | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-07-06 | 450 SW 8TH STREET, MIAMI, FL 33130 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001322966 | TERMINATED | 1000000464987 | MIAMI-DADE | 2013-08-19 | 2033-09-05 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J11000495494 | ACTIVE | 1000000227582 | DADE | 2011-07-28 | 2031-08-03 | $ 1,520.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SOUTH SERVICE CENTER, 8175 NW 12TH ST STE 418, MIAMI FL331261828 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2011-10-13 |
| Amendment | 2011-03-16 |
| ANNUAL REPORT | 2010-05-06 |
| ANNUAL REPORT | 2009-06-01 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-28 |
| ANNUAL REPORT | 2006-04-27 |
| ANNUAL REPORT | 2005-07-06 |
| Domestic Profit | 2004-06-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
