| Entity Name: | VALENCIA MEDICAL CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Dec 2009 (15 years ago) |
| Document Number: | P09000098407 |
| FEI/EIN Number | 271445294 |
| Address: | 9804 SW 40 ST, MIAMI, FL, 33165 |
| Mail Address: | P.O. BOX 347768, MIAMI, FL, 33234 |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649598418 | 2010-05-04 | 2022-11-04 | 9804 SW 40TH ST, MIAMI, FL, 331653912, US | 9804 SW 40TH ST, MIAMI, FL, 331653912, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-222-9154 |
| Fax | 3052229155 |
Authorized person
| Name | MRS. JUDITH VALENCIA |
| Role | PRESIDENT |
| Phone | 3052229154 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | ME98844 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | PQ912 |
| State | FL |
| Issuer | MEDICAID |
| Number | 115804400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VALENCIA JUDITH | Agent | 4001 SW 4 ST, MIAMI, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| VALENCIA JUDITH | President | 4001 SW 4 ST, MIAMI, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| VALENCIA JUDITH | Secretary | 4001 SW 4 ST, MIAMI, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| VALENCIA JUDITH | Director | 4001 SW 4 ST, MIAMI, FL, 33134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-05 | 9804 SW 40 ST, MIAMI, FL 33165 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-05 | 9804 SW 40 ST, MIAMI, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-04-03 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
