| Entity Name: | ENRIQUE DIAZ MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Jul 2008 (17 years ago) |
| Document Number: | P08000066858 |
| FEI/EIN Number | 263018935 |
| Address: | 9995 SW Sunset Dr, MIAMI, FL, 33173, US |
| Mail Address: | 8299 SW 110th Ter, MIAMI, FL, 33156, US |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215192042 | 2008-07-21 | 2012-10-22 | 9995 SW 72ND ST, SUITE 208, MIAMI, FL, 331734662, US | 8720 N KENDALL DR, SUITE 211, MIAMI, FL, 331762299, US | |||||||||||||||||||||||||
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| Phone | +1 305-412-6034 |
| Fax | 3054126686 |
Authorized person
| Name | DR. ENRIQUE DIAZ |
| Role | PRESIDENT |
| Phone | 7865257255 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME100582 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FL LICENSE |
| Number | ME100582 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DIAZ ENRIQUE M | Agent | 9995 SW Sunset Dr, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| DIAZ ENRIQUE M | Manager | 9995 SW Sunset Dr, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| DIAZ ENRIQUE M | Director | 9995 SW Sunset Dr, MIAMI, FL, 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-04-22 | 9995 SW Sunset Dr, 208, MIAMI, FL 33173 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-27 | 9995 SW Sunset Dr, 208, MIAMI, FL 33173 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-27 | 9995 SW Sunset Dr, 208, MIAMI, FL 33173 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-25 |
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-05-02 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-02-26 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-02-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
