| Entity Name: | PALM LAKE MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Jun 2006 (19 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P06000087598 |
| FEI/EIN Number | 205127588 |
| Address: | 4715 NW 157TH STREET #115, MIAMI, FL, 33014 |
| Mail Address: | 4715 NW 157TH STREET #115, MIAMI, FL, 33014 |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245361518 | 2007-03-08 | 2020-08-22 | 4715 NW 157TH ST, SUITE 111-115, HIALEAH, FL, 330146435, US | 4715 NW 157TH ST, SUITE 111-115, HIALEAH, FL, 330146435, US | |||||||||||||
|
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| Phone | +1 305-405-2939 |
Authorized person
| Name | ANGEL GARCIA |
| Role | PRESIDENT |
| Phone | 3055764291 |
Taxonomy
| Taxonomy Code | 170100000X - Ph.D. Medical Genetics |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ROSA ANGEL R | Agent | 4715 NW 157TH STREET #115, MIAMI, FL, 33015 |
| Name | Role | Address |
|---|---|---|
| ROSA ANGEL R | President | 600 NE 25 STREET, #60, MIAMI, FL, 33137 |
| Name | Role | Address |
|---|---|---|
| PAZ JOSE R | Secretary | 3000 SW 129 AVE., MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| BETANCOURT ANGEL G | Treasurer | 7995 W. 29 WAY #101, HIALEAH, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ MARTA | Director | 4715 NW 157TH STREET #115, MIAMI, FL, 33015 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| AMENDMENT | 2009-03-31 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-03-18 | 4715 NW 157TH STREET #115, MIAMI, FL 33014 | No data |
| CHANGE OF MAILING ADDRESS | 2008-03-18 | 4715 NW 157TH STREET #115, MIAMI, FL 33014 | No data |
| AMENDMENT | 2008-03-12 | No data | No data |
| Name | Date |
|---|---|
| Amendment | 2009-03-31 |
| ANNUAL REPORT | 2008-03-18 |
| Amendment | 2008-03-12 |
| ANNUAL REPORT | 2007-02-22 |
| Domestic Profit | 2006-06-28 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
