| Entity Name: | LA MAISON MEDICAL PRACTICE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Aug 2009 (16 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P09000065450 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 6595 NW 36 ST, STE 200, MIAMI, FL, 33166, US |
| Mail Address: | P.O. BOX 522215, MIAMI, FL, 33152 |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275764698 | 2009-08-03 | 2009-10-07 | 6595 NW 36 STREET, SUITE 200, MIAMI, FL, 33166, US | 6595 NW 36 STREET, SUITE 200, MIAMI, FL, 33166, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 305-492-0010 |
| Fax | 3054920011 |
Authorized person
| Name | MAYLIN VALDES |
| Role | PRESIDENT |
| Phone | 3054920010 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | MA49444 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HEALTHCARE LICENSE |
| Number | MA49444 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VALDES MAYLIN | Agent | 6595 NW 36 ST, STE 200, MIAMI, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| VALDES MAYLIN | President | 6595 NW 36 ST, STE 200, MIAMI, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| VALDES MAYLIN | Secretary | 6595 NW 36 ST, STE 200, MIAMI, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| VALDES MAYLIN | Director | 6595 NW 36 ST, STE 200, MIAMI, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2011-01-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| AMENDMENT | 2010-06-18 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-06-18 | 6595 NW 36 ST, STE 200, MIAMI, FL 33166 | No data |
| AMENDMENT | 2009-12-14 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-10-01 | 6595 NW 36 ST, STE 200, MIAMI, FL 33166 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-09-30 | 6595 NW 36 ST, STE 200, MIAMI, FL 33166 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2011-01-03 |
| Amendment | 2010-06-18 |
| Amendment | 2009-12-14 |
| Reg. Agent Change | 2009-10-01 |
| Domestic Profit | 2009-08-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
