| Entity Name: | EVELYN DIAGNOSTIC & MEDICAL GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Jan 2006 (19 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P06000003451 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 1840 W 49TH ST, SUITE: 227, HIALEAH, FL, 33012, US |
| Mail Address: | 1840 W 49TH ST, SUITE: 227, HIALEAH, FL, 33012, US |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124220470 | 2007-05-31 | 2008-06-27 | 7000 W 12TH AVE, SUITE 15, HIALEAH, FL, 330145154, US | 7000 W 12TH AVE, SUITE 15, HIALEAH, FL, 330145154, US | |||||||||||||||||||||
|
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| Phone | +1 305-512-1850 |
| Fax | 3055121851 |
Authorized person
| Name | ERNESTO M CARRALERO |
| Role | PRESIDENT |
| Phone | 3055121850 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HEALTH CARE CLINIC |
| Number | HCC5649 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARRALERO ERNESTO M | Agent | 1840 W 49TH ST, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| CARRALERO ERNESTO M | President | 1840 W 49TH ST - SUITE: 227, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| CARRALERO ERNESTO M | Director | 1840 W 49TH ST - SUITE: 227, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-29 | 1840 W 49TH ST, SUITE: 227, HIALEAH, FL 33012 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-29 | 1840 W 49TH ST, SUITE: 227, HIALEAH, FL 33012 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-29 | 1840 W 49TH ST, SUITE: 227, HIALEAH, FL 33012 | No data |
| AMENDMENT | 2006-12-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2006-12-28 | CARRALERO, ERNESTO M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-28 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-04-30 |
| Off/Dir Resignation | 2007-11-13 |
| ANNUAL REPORT | 2007-04-28 |
| Amendment | 2006-12-28 |
| Domestic Profit | 2006-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
