| Entity Name: | PONCE HOME MEDICAL EQUIPMENT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 26 Jun 2007 (18 years ago) |
| Date of dissolution: | 14 Jan 2013 (12 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 14 Jan 2013 (12 years ago) |
| Document Number: | P07000073965 |
| FEI/EIN Number | 260428777 |
| Address: | 166 HERONS NEST LANE, ST. AUGUSTINE, FL, 32080 |
| Mail Address: | 166 HERONS NEST LANE, ST. AUGUSTINE, FL, 32080 |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790931871 | 2008-08-08 | 2011-09-16 | PO BOX 3123, ST AUGUSTINE, FL, 320853123, US | 1100 PLANTATION ISLAND DR S, SUITE 140, ST AUGUSTINE, FL, 320806188, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-824-4990 |
| Fax | 9048242226 |
| Phone | +1 904-461-9050 |
| Fax | 9044619060 |
Authorized person
| Name | BETTY CARVAJAL-PANTALEON |
| Role | OWNER |
| Phone | 9044619050 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1313412 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000535300 |
| State | FL |
| Issuer | DOL |
| Number | 613159001 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARVAJAL-PANTALEON BETTY | Agent | 1100 PLANTATION ISLAND DR, SOUTH, ST. AUGUSTINE, FL, 32080 |
| Name | Role | Address |
|---|---|---|
| CARVAJAL-PANTALEON BETTY | Director | 1100 PLANTATION ISLAND DRIVE STE 140, ST. AUGUSTINE, FL, 32080 |
| Name | Role | Address |
|---|---|---|
| CARVAJAL-PANTALEON BETTY | President | 1100 PLANTATION ISLAND DRIVE STE 140, ST. AUGUSTINE, FL, 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-01-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-09-10 | 166 HERONS NEST LANE, ST. AUGUSTINE, FL 32080 | No data |
| CHANGE OF MAILING ADDRESS | 2012-09-10 | 166 HERONS NEST LANE, ST. AUGUSTINE, FL 32080 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-09-02 | 1100 PLANTATION ISLAND DR, SOUTH, SUITE 140, ST. AUGUSTINE, FL 32080 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-09-02 | CARVAJAL-PANTALEON, BETTY | No data |
| REINSTATEMENT | 2011-03-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12000090210 | TERMINATED | 1000000249661 | ST JOHNS | 2012-02-03 | 2032-02-08 | $ 2,700.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-01-14 |
| ANNUAL REPORT | 2012-02-20 |
| ANNUAL REPORT | 2011-09-02 |
| REINSTATEMENT | 2011-03-08 |
| ANNUAL REPORT | 2009-08-06 |
| ANNUAL REPORT | 2008-01-14 |
| Domestic Profit | 2007-06-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
