| Entity Name: | HOMESTEAD PEDIATRIC ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Apr 2005 (20 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 May 2005 (20 years ago) |
| Document Number: | P05000053188 |
| FEI/EIN Number | 043817319 |
| Address: | 975 BAPTIST WAY, HOMESTEAD, FL, 33033, US |
| Mail Address: | 975 BAPTIST WAY, HOMESTEAD, FL, 33033, US |
| ZIP code: | 33033 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1669469771 | 2005-10-04 | 2013-09-28 | 975 BAPTIST WAY, SUITE 103, HOMESTEAD, FL, 330337600, US | 975 BAPTIST WAY, SUITE 103, HOMESTEAD, FL, 330337600, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-245-4549 |
| Fax | 3052454590 |
Authorized person
| Name | DR. DANETTE TORRES |
| Role | PRESIDENT |
| Phone | 3052454549 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME83861 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUECROSSBLUESHIELD |
| Number | 29246 |
| State | FL |
| Issuer | AMERIGROUP |
| Number | 194198 |
| State | FL |
| Issuer | JMH |
| Number | 178147 |
| State | FL |
| Issuer | MEDICAID |
| Number | 272565700 |
| State | FL |
| Issuer | DIMENSION |
| Number | 11071 |
| State | FL |
| Issuer | AVMED |
| Number | 297302 |
| State | FL |
| Issuer | VISTA |
| Number | SG078319/H922 |
| State | FL |
| Issuer | CIGNA |
| Number | 4554532 |
| State | FL |
| Issuer | NHP |
| Number | 52761-83861 |
| State | FL |
| Issuer | FIRSTHEALTH |
| Number | 5666752 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TORRES DANETTE M | Agent | 975 BAPTIST WAY, HOMESTEAD, FL, 33033 |
| Name | Role | Address |
|---|---|---|
| TORRES DANETTE M | President | 975 BAPTIST WAY, HOMESTEAD, FL, 33033 |
| Name | Role | Address |
|---|---|---|
| PERNAS MARTHA B | Secretary | 975 BAPTIST WAY, HOMESTEAD, FL, 33033 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-13 | 975 BAPTIST WAY, SUITE 103, HOMESTEAD, FL 33033 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-13 | 975 BAPTIST WAY, SUITE 103, HOMESTEAD, FL 33033 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-13 | 975 BAPTIST WAY, SUITE 103, HOMESTEAD, FL 33033 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-01-07 | TORRES, DANETTE MD | No data |
| AMENDMENT | 2005-05-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-13 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-01-16 |
| ANNUAL REPORT | 2022-01-11 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-01-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
