| Entity Name: | WESTERN COMMUNITIES INTERNAL MEDICINE, CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Jan 2008 (17 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P08000006770 |
| FEI/EIN Number | 261787150 |
| Address: | 12955 PALMS WEST DRIVE, 202, LOXAHATCHEEL, FL, 33470 |
| Mail Address: | 12955 PALMS WEST DRIVE, 202, LOXAHATCHEEL, FL, 33470 |
| ZIP code: | 33470 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043483035 | 2008-04-10 | 2018-06-21 | 10115 FOREST HILL BLVD, SUITE 104, WELLINGTON, FL, 334143105, US | 10115 FOREST HILL BLVD, SUITE 104, WELLINGTON, FL, 334143105, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 561-793-1117 |
| Fax | 5617931762 |
Authorized person
| Name | MARIO F GUILLEN |
| Role | PRESIDENT/OWNER |
| Phone | 5613857004 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME84093 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HUOTT COLLEEN E | Agent | 4300 N. UNIVERSITY DR., LAUDERHILL, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| GUILLEN MARIO D | Director | 11111 LAUREL WALK RD., WELLINGTON, FL, 33449 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2011-04-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-07 | 12955 PALMS WEST DRIVE, 202, LOXAHATCHEEL, FL 33470 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-07 | 12955 PALMS WEST DRIVE, 202, LOXAHATCHEEL, FL 33470 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CANCEL ADM DISS/REV | 2009-10-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001167668 | LAPSED | 1000000505251 | PALM BEACH | 2013-05-22 | 2023-07-03 | $ 615.03 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| J13000447608 | LAPSED | 1000000343542 | PALM BEACH | 2013-01-08 | 2023-02-20 | $ 984.27 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2011-04-07 |
| REINSTATEMENT | 2009-10-12 |
| Domestic Profit | 2008-01-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
