| Entity Name: | JOHN C. AYALA M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 May 2006 (19 years ago) |
| Document Number: | P06000069253 |
| FEI/EIN Number | 204894442 |
| Address: | 3659 S Miami Ave, SUITE 4004, MIAMI, FL, 33133, US |
| Mail Address: | 3659 S Miami Ave, SUITE 4004, MIAMI, FL, 33133, US |
| ZIP code: | 33133 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376653535 | 2006-08-30 | 2009-03-23 | 7000 SW 97TH AVE, SUITE 108, MIAMI, FL, 331731494, US | 7000 SW 97TH AVE, SUITE 108, MIAMI, FL, 331731494, US | |||||||||||||||||||||||||
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| Phone | +1 305-598-5232 |
| Fax | 3055985236 |
Authorized person
| Name | DR. JOHN C. AYALA |
| Role | PRESIDENT |
| Phone | 3055985232 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME79087 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 257331800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AYALA JOHN C | Agent | 8855 COLLINS AVENUE, SURFSIDE, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| AYALA JOHN C | President | 3659 S. MIAMI AVENUE, MIAMI, FL, 33133 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-07 | 3659 S Miami Ave, SUITE 4004, MIAMI, FL 33133 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-07 | 3659 S Miami Ave, SUITE 4004, MIAMI, FL 33133 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-23 | 8855 COLLINS AVENUE, APT 11-B, SURFSIDE, FL 33154 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-22 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6274407306 | 2020-04-30 | 0455 | PPP | 8855 COLLINS AVE APT 11B, SURFSIDE, FL, 33154-3439 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
