| Entity Name: | OBANGUALA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 May 2009 (16 years ago) |
| Document Number: | P09000040520 |
| FEI/EIN Number | 80-0407244 |
| Address: | 719 EAST 9TH STREET, HIALEAH, FL 33010 |
| Mail Address: | 14531 HARRIS PL., MIAMI LAKES, FL 33014 |
| ZIP code: | 33010 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629385661 | 2010-09-13 | 2014-08-05 | 719 E 9TH ST, HIALEAH, FL, 330104553, US | 719 E 9TH ST, HIALEAH, FL, 330104553, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 305-863-7307 |
| Fax | 3058637347 |
Authorized person
| Name | MARIANA P ABRAHAM |
| Role | PRESIDENT |
| Phone | 3058637307 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001248200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 003014900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ABRAHAM, MARIANA P | Agent | 14531 HARRIS PL., MIAMI LAKES, FL 33014 |
| Name | Role | Address |
|---|---|---|
| ABRAHAM, MARIANA P | President | 14531 HARRIS PL, MIAMI LAKES, FL 33014 |
| Name | Role | Address |
|---|---|---|
| SANCHEZ, MASSIEL | Secretary | 3115 NW 98 ST, MIAMI, FL 33147 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, ROBERTO | Vice President | 14531 HARRIS PL., MIAMI LAKES, FL 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-01-23 | 719 EAST 9TH STREET, HIALEAH, FL 33010 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-01-23 | 14531 HARRIS PL., MIAMI LAKES, FL 33014 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-17 | 719 EAST 9TH STREET, HIALEAH, FL 33010 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-25 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-01-23 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-02-21 |
| ANNUAL REPORT | 2016-02-02 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
