| Entity Name: | MIAMI ACCIDENT CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Jun 2009 (16 years ago) |
| Document Number: | P09000052672 |
| FEI/EIN Number | 270406108 |
| Address: | 3727 S.W. 8 ST., 102, CORAL GABLES, FL, 33134 |
| Mail Address: | P.O. BOX 430746, MIAMI, FL, 33243 |
| ZIP code: | 33134 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003045055 | 2009-07-13 | 2009-07-13 | PO BOX 430746, MIAMI, FL, 332430746, US | 3727 SW 8TH ST STE 102, CORAL GABLES, FL, 331343158, US | |||||||||||||||||||||||||||||||
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| Phone | +1 786-380-6652 |
| Fax | 3054412509 |
Authorized person
| Name | DR. JEANETTE DIAZ |
| Role | DOCTOR OF CHIROPRACTIC |
| Phone | 7863806652 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH9231 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 382305900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 3980201900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DIAZ JEANETTE | Agent | 3727 S.W. 8 st, MIAMI, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| DIAZ JEANETTE | President | P.O. BOX 430746, MIAMI, FL, 33243 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-23 | 3727 S.W. 8 st, 102, MIAMI, FL 33134 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J10000829165 | TERMINATED | 09-13635SP25 | MIAMI-DADE CNTY CRT CIV | 2010-08-02 | 2015-08-09 | $5,453.83 | DEREK R. CROISSIERT, P.O. BOX 331302, MIAMI, FL 33233 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-01-23 |
| ANNUAL REPORT | 2016-03-23 |
| ANNUAL REPORT | 2015-03-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
