| Entity Name: | FORTUNE SMILES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Jul 2009 (16 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Oct 2010 (14 years ago) |
| Document Number: | P09000063949 |
| FEI/EIN Number | 27-0645885 |
| Address: | 1843 sw 8th street, Miami, FL, 33135, US |
| Mail Address: | 6300 SW 33 St., Miami, FL, 33155, US |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982077939 | 2015-11-12 | 2015-11-12 | 2879 S UNIVERSITY DR, DAVIE, FL, 333281440, US | 2879 S UNIVERSITY DR, DAVIE, FL, 333281440, US | |||||||||||||||||||||||||
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| Phone | +1 954-474-2499 |
| Fax | 9544741966 |
Authorized person
| Name | DR. MADELENE MICHELLE TRUJILLO |
| Role | DENTIST |
| Phone | 3052599120 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | D18770 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 013776 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TRUJILLO MADELENE | Agent | 6300 SW 33 St., Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| TRUJILLO MADELENE | Director | 1843 SW 8TH ST., MIAMI, FL, 33135 |
| Acosta Tomas | Director | 1843 sw 8th street, Miami, FL, 33135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-06-22 | 1843 sw 8th street, Miami, FL 33135 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-06-22 | 6300 SW 33 St., Miami, FL 33155 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-04 | 1843 sw 8th street, Miami, FL 33135 | No data |
| REINSTATEMENT | 2010-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000083494 | LAPSED | 1000000287041 | MIAMI-DADE | 2012-10-19 | 2023-01-16 | $ 447.70 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-04-24 |
| AMENDED ANNUAL REPORT | 2021-06-22 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-03-04 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-02-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
