| Entity Name: | LUIS R. CACERES, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 02 Feb 2005 (20 years ago) |
| Document Number: | P05000017228 |
| FEI/EIN Number | 86-1129148 |
| Address: | 9290 S.W. 72ND ST., SUITE 103, MIAMI, FL 33173 |
| Mail Address: | 9290 S.W. 72ND ST., SUITE 103, MIAMI, FL 33173 |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821131509 | 2007-02-14 | 2020-08-22 | 9260 SW 72ND ST, SUITE 115, MIAMI, FL, 331733275, US | 9260 SW 72ND ST, SUITE 115, MIAMI, FL, 331733275, US | |||||||||||||||||||||||||
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| Phone | +1 305-271-8383 |
| Fax | 3052718448 |
Authorized person
| Name | DR. LUIS R. CACERES III |
| Role | PRESIDENT |
| Phone | 3052718383 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | OS7681 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI |
| Number | 1528053063 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| POMARES, FERNANDO | Agent | 12002 S.W. 128 Ct., SUITE 104, MIAMI, FL 33186 |
| Name | Role | Address |
|---|---|---|
| CACERES, LUIS R | President | 9830 SW 19TH STREET, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| CACERES, LUIS R | Director | 9830 SW 19TH STREET, MIAMI, FL 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-10 | 9290 S.W. 72ND ST., SUITE 103, MIAMI, FL 33173 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-10 | 9290 S.W. 72ND ST., SUITE 103, MIAMI, FL 33173 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-25 | 12002 S.W. 128 Ct., SUITE 104, MIAMI, FL 33186 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-28 |
| ANNUAL REPORT | 2022-03-19 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-03-10 |
| ANNUAL REPORT | 2018-02-04 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-01-20 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
