| Entity Name: | NEUROLOGY CONSULTANTS OF SOUTH FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
NEUROLOGY CONSULTANTS OF SOUTH FLORIDA, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 23 Aug 2004 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 15 Oct 2018 (7 years ago) |
| Document Number: | P04000121660 |
| FEI/EIN Number |
201528804
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4160 W. 16TH AVE.,, SUITE#100, HIALEAH, FL, 33012 |
| Mail Address: | 4160 W. 16TH AVE.,, SUITE#100, HIALEAH, FL, 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417017823 | 2006-12-08 | 2010-07-19 | PO BOX 126629, HIALEAH, FL, 330121610, US | 4160 W 16TH AVE, SUITE 100, HIALEAH, FL, 330125853, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-826-5655 |
| Fax | 3058265598 |
Authorized person
| Name | DR. MARTHA BUSTAMANTE |
| Role | PRESIDENT |
| Phone | 3058265655 |
Taxonomy
| Taxonomy Code | 2084N0008X - Neuromuscular Medicine (Psychiatry & Neurology) Physician |
| License Number | ME58534 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | ME58534 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084N0402X - Neurology with Special Qualifications in Child Neurology Physician |
| License Number | ME58534 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 2084P0005X - Neurodevelopmental Disabilities Physician |
| License Number | ME58534 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD FL |
| Number | 99443 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BUSTAMANTE MARTHA | President | 4160 W. 16TH AVE., #100, HIALEAH, FL, 33012 |
| ZOMERFELD RAYMOND J | Agent | 355 Alhambra Circle, CORAL GABLES, FL, 33134 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000119343 | MARTHA BUSTAMANTE MD | ACTIVE | 2020-09-14 | 2025-12-31 | - | 4160 WEST 16TH AVE, STE 100, HIALEAH, FL, 33012 |
| G08310900258 | MARTHA BUSTAMANTE MD | EXPIRED | 2008-11-05 | 2013-12-31 | - | 4160 WEST 16TH AVE, SUITE#100, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-13 | 355 Alhambra Circle, Suite 1100, CORAL GABLES, FL 33134 | - |
| REINSTATEMENT | 2018-10-15 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | - | - |
| REINSTATEMENT | 2017-10-30 | - | - |
| REGISTERED AGENT NAME CHANGED | 2017-10-30 | ZOMERFELD, RAYMOND J | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-29 | 4160 W. 16TH AVE.,, SUITE#100, HIALEAH, FL 33012 | - |
| CHANGE OF MAILING ADDRESS | 2010-04-29 | 4160 W. 16TH AVE.,, SUITE#100, HIALEAH, FL 33012 | - |
| CANCEL ADM DISS/REV | 2005-10-11 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | - | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000769463 | TERMINATED | 1000000804144 | DADE | 2018-11-15 | 2028-11-21 | $ 604.78 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-09-14 |
| ANNUAL REPORT | 2019-03-13 |
| REINSTATEMENT | 2018-10-15 |
| REINSTATEMENT | 2017-10-30 |
| ANNUAL REPORT | 2016-01-17 |
| ANNUAL REPORT | 2015-01-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5248487310 | 2020-04-30 | 0455 | PPP | 4160 WEST 16 AVENUE SUITE 100, HIALEAH, FL, 33012 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
