| Entity Name: | DEL PRADO MEDICAL CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Jul 2008 (17 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 24 Feb 2017 (8 years ago) |
| Document Number: | P08000070564 |
| FEI/EIN Number | 263057877 |
| Address: | 2500 DEL PRADO BLVD S, CAPE CORAL, FL, 33904, US |
| Mail Address: | 2500 DEL PRADO BLVD S, CAPE CORAL, FL, 33904, US |
| ZIP code: | 33904 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982855359 | 2008-10-03 | 2024-07-29 | 2500 DEL PRADO BLVD S, CAPE CORAL, FL, 339045750, US | 2500 DEL PRADO BLVD S, CAPE CORAL, FL, 339045750, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-772-1194 |
| Fax | 2397721196 |
Authorized person
| Name | DAISY MARTINEZ |
| Role | OWNER/PRESIDENT |
| Phone | 2397721194 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | BD041 |
| State | FL |
| Issuer | MEDICAID |
| Number | 022008300 |
| State | FL |
| Issuer | MEDICAID |
| Number | 022008301 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARTINEZ DAISY | Agent | 2500 DEL PRADO BLVD S, CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ DAISY | President | 2500 DEL PRADO BLVD S, CAPE CORAL, FL, 33904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-02-24 | MARTINEZ, DAISY | No data |
| AMENDMENT | 2017-02-24 | No data | No data |
| AMENDMENT | 2013-11-18 | No data | No data |
| AMENDMENT | 2013-07-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-01-20 | 2500 DEL PRADO BLVD S, CAPE CORAL, FL 33904 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-20 | 2500 DEL PRADO BLVD S, CAPE CORAL, FL 33904 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-20 | 2500 DEL PRADO BLVD S, CAPE CORAL, FL 33904 | No data |
| AMENDMENT | 2008-08-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-19 |
| ANNUAL REPORT | 2022-02-24 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-27 |
| Amendment | 2017-02-24 |
| ANNUAL REPORT | 2016-04-27 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
