| Entity Name: | HOMESTEADMED, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Dec 2005 (19 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P05000167473 |
| FEI/EIN Number | 204007956 |
| Address: | 2640 FAIRWAYS DR., HOMESTEAD, FL, 33035, US |
| Mail Address: | 2640 FAIRWAYS DR., HOMESTEAD, FL, 33035, US |
| ZIP code: | 33035 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578526737 | 2006-04-10 | 2020-08-22 | PO BOX 863997, ORLANDO, FL, 328863997, US | 160 NW 13TH ST, HOMESTEAD, FL, 330304228, US | |||||||||||||||||||||||||
|
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| Phone | +1 786-243-8000 |
Authorized person
| Name | DR. JAMES FISH |
| Role | PRESIDENT |
| Phone | 8663966418 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 24126 |
| State | FL |
| Issuer | RAILROAD |
| Number | DF5448 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LYNN SANDRA T | Agent | 7 Barracuda Lane, Key Largo, FL, 33037 |
| Name | Role | Address |
|---|---|---|
| FISH JAMES A | President | 2640 FAIRWAYS DRIVE, HOMESTEAD, FL, 33035 |
| Name | Role | Address |
|---|---|---|
| FISH JAMES A | Secretary | 2640 FAIRWAYS DRIVE, HOMESTEAD, FL, 33035 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-29 | 7 Barracuda Lane, Key Largo, FL 33037 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-08-02 | 2640 FAIRWAYS DR., HOMESTEAD, FL 33035 | No data |
| CHANGE OF MAILING ADDRESS | 2011-08-02 | 2640 FAIRWAYS DR., HOMESTEAD, FL 33035 | No data |
| AMENDMENT AND NAME CHANGE | 2006-02-06 | HOMESTEADMED, PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-29 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-24 |
| ANNUAL REPORT | 2011-04-28 |
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-28 |
| ANNUAL REPORT | 2008-04-23 |
| ANNUAL REPORT | 2007-04-27 |
| ANNUAL REPORT | 2006-05-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
