| Entity Name: | DENTAL GROUP OF SOUTH FLORIDA, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Aug 2006 (18 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 15 Dec 2008 (16 years ago) |
| Document Number: | P06000103687 |
| FEI/EIN Number | 205358315 |
| Address: | 13419 SW 56 STREET, MIAMI, FL, 33175, US |
| Mail Address: | 13419 SW 56TH STREET, MIAMI, FL, 33175, US |
| ZIP code: | 33175 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073720645 | 2007-05-16 | 2019-11-01 | 13419 SW 56 ST, MIAMI, FL, 33175, US | 13419 SW 56 ST, MIAMI, FL, 33175, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-559-2663 |
| Fax | 3055593040 |
Authorized person
| Name | MS. MARIA JOSEFINA ALVAREZ |
| Role | PRESIDENT |
| Phone | 3054448591 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN17638 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN11187 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1223P0300X - Periodontist |
| License Number | DN12021 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | DN16376 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 124Q00000X - Dental Hygienist |
| License Number | DH16946 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 076710700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALVAREZ MARIA J | Agent | 13419 SW 56TH STREET, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ MARIA J | President | 13419 SW 56TH STREET, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ JOHN L | Secretary | 13419 SW 56TH STREET, MIAMI, FL, 33175 |
| ALVAREZ GEORGE J | Secretary | 13419 SW 56TH STREET, MIAMI, FL, 33175 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-17 | 13419 SW 56 STREET, MIAMI, FL 33175 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-17 | 13419 SW 56 STREET, MIAMI, FL 33175 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-17 | 13419 SW 56TH STREET, MIAMI, FL 33175 | No data |
| AMENDMENT | 2008-12-15 | No data | No data |
| NAME CHANGE AMENDMENT | 2007-01-08 | DENTAL GROUP OF SOUTH FLORIDA, INC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-06-17 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
