| Entity Name: | JORGE RUIZ LLANES, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 May 2006 (19 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P06000064125 |
| FEI/EIN Number | 651279021 |
| Address: | 700 SE 5TH TERRACE, SUITE 5, CRYSTAL RIVER, FL, 34429, US |
| Mail Address: | P.O. BOX 8006, WESLACO, TX, 78599, US |
| ZIP code: | 34429 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477711844 | 2008-06-01 | 2010-01-12 | PO BOX 1240, LECANTO, FL, 344601240, US | 700 SE 5TH TER, SUITE 2, CRYSTAL RIVER, FL, 344294878, US | |||||||||||||||||||||||||
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| Phone | +1 352-794-3882 |
| Fax | 3527943883 |
Authorized person
| Name | JORGE RUIZ LLANES |
| Role | PRESIDENT |
| Phone | 3527943882 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME94400 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 276138600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RUIZ LLANES JORGE | Agent | 1896 N. RAVENWOOD PT, HERNANDO, FL, 34442 |
| Name | Role | Address |
|---|---|---|
| RUIZ LLANES JORGE M | President | 1896 N. RAVENWOOD PT, HERNANDO, FL, 34442 |
| Name | Role | Address |
|---|---|---|
| RUIZ LLANES JORGE M | Treasurer | 1896 N. RAVENWOOD PT, HERNANDO, FL, 34442 |
| Name | Role | Address |
|---|---|---|
| RUIZ VIVIANA | Vice President | 1896 N. RAVENWOOD PT, HERNANDO, FL, 34442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-27 | 700 SE 5TH TERRACE, SUITE 5, CRYSTAL RIVER, FL 34429 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-12 | 700 SE 5TH TERRACE, SUITE 5, CRYSTAL RIVER, FL 34429 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-21 | 1896 N. RAVENWOOD PT, HERNANDO, FL 34442 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-23 | RUIZ LLANES, JORGE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-02-27 |
| ANNUAL REPORT | 2013-03-05 |
| ANNUAL REPORT | 2012-03-12 |
| ANNUAL REPORT | 2011-02-05 |
| ANNUAL REPORT | 2010-02-21 |
| ANNUAL REPORT | 2009-03-23 |
| ANNUAL REPORT | 2008-02-29 |
| ANNUAL REPORT | 2007-03-14 |
| Domestic Profit | 2006-05-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
