| Entity Name: | COMMUNITY MEDICAL CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 Apr 2006 (19 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P06000052858 |
| FEI/EIN Number | 204685457 |
| Address: | 531 EAST 25 STREET, HIALEAH, FL, 33013, US |
| Mail Address: | 531 EAST 25 STREET, HIALEAH, FL, 33013, US |
| ZIP code: | 33013 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972603942 | 2006-09-22 | 2020-08-22 | 531 E 25TH ST, HIALEAH, FL, 330133812, US | 531 E 25TH ST, HIALEAH, FL, 330133812, US | |||||||||||||||||||||||||
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| Phone | +1 305-694-9364 |
| Fax | 3056949375 |
Authorized person
| Name | MRS. ELENA ROSELLO |
| Role | PRESIDENT |
| Phone | 3056949364 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME83652 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA LICENSE |
| Number | HCC7234 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROSELLO JOEL | Agent | 531 EAST 25 STREET, HIALEAH, FL, 33013 |
| Name | Role | Address |
|---|---|---|
| ROSELLO JOEL | President | 531 EAST 25 ST, HIALEAH, FL, 33013 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| AMENDMENT | 2011-03-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-22 | ROSELLO, JOEL | No data |
| AMENDMENT | 2010-09-14 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-07-22 | 531 EAST 25 STREET, HIALEAH, FL 33013 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-07-22 | 531 EAST 25 STREET, HIALEAH, FL 33013 | No data |
| CHANGE OF MAILING ADDRESS | 2010-07-22 | 531 EAST 25 STREET, HIALEAH, FL 33013 | No data |
| AMENDMENT | 2006-05-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-02 |
| ANNUAL REPORT | 2017-03-13 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-03-09 |
| ANNUAL REPORT | 2014-03-18 |
| ANNUAL REPORT | 2013-02-28 |
| ANNUAL REPORT | 2012-02-15 |
| ANNUAL REPORT | 2011-04-25 |
| Amendment | 2011-03-22 |
| Amendment | 2010-09-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
