| Entity Name: | ANAISYS M. BALLESTEROS, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Jun 2004 (21 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P04000098481 |
| FEI/EIN Number | 201315165 |
| Address: | 9290 SW 72 ST, SUITE 105, MIAMI, FL, 33173, US |
| Mail Address: | 9290 SW 72 ST, SUITE 105, MIAMI, FL, 33173 |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750488326 | 2006-09-17 | 2020-08-22 | 9290 SW 72ND ST, SUITE 105, MIAMI, FL, 331733236, US | 9290 SW 72ND ST, SUITE 105, MIAMI, FL, 331733236, US | |||||||||||||||||||
|
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| Phone | +1 305-275-6202 |
| Fax | 3052756203 |
Authorized person
| Name | DR. ANAISYS MARIA BALLESTEROS |
| Role | PRESIDENT |
| Phone | 3052756202 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS8354 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GARCIA MICHAEL A | Agent | 100 SE 2ND ST 18TH FL, MIAMI, FL, 33176 |
| Name | Role | Address |
|---|---|---|
| BALLESTEROS ANAISYS M | Director | 9290 SW 72 ST, SUITE 105, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| BALLESTEROS ANAISYS M | President | 9290 SW 72 ST, SUITE 105, MIAMI, FL, 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-04-28 | 9290 SW 72 ST, SUITE 105, MIAMI, FL 33173 | No data |
| CHANGE OF MAILING ADDRESS | 2006-04-28 | 9290 SW 72 ST, SUITE 105, MIAMI, FL 33173 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-27 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-09-27 |
| ANNUAL REPORT | 2011-05-03 |
| ANNUAL REPORT | 2010-04-30 |
| ANNUAL REPORT | 2009-04-29 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-19 |
| ANNUAL REPORT | 2006-04-28 |
| ANNUAL REPORT | 2005-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
