| Entity Name: | SOUTH FLORIDA MEDICAL CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 Jan 2010 (15 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P10000004500 |
| Address: | 3129 S. FLORIDA AVE, LAKELAND, FL 33803 |
| Mail Address: | 3129 S. FLORIDA AVE, LAKELAND, FL 33803 |
| ZIP code: | 33803 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740511120 | 2010-01-25 | 2010-01-25 | 3129 S FLORIDA AVE, LAKELAND, FL, 338034563, US | 3129 S FLORIDA AVE, LAKELAND, FL, 338034563, US | |||||||||||||||||
|
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| Phone | +1 813-484-9185 |
Authorized person
| Name | DR. HECTOR R COLLAZO-RAMIS |
| Role | DIRECTOR |
| Phone | 8134849185 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME67822 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VORPOS, ANA M | Agent | 8001 N. DALE MABRY HWY BLDG 701, TAMPA, FL 33614 |
| Name | Role | Address |
|---|---|---|
| COLLAZO, HECTOR | Director | 5825 LAKE CHAMPLAIN DR, ORLANDO, FL 32829 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000010431 | DOCTORS N US WALK-IN CLINIC | EXPIRED | 2011-01-26 | 2016-12-31 | No data | 6821 W HILLSBOROUGH AVE SUITE#19, TAMPA, FL, 33634 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2011-10-05 | 8001 N. DALE MABRY HWY BLDG 701, TAMPA, FL 33614 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-10-04 | VORPOS, ANA M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| Reg. Agent Change | 2011-10-04 |
| Domestic Profit | 2010-01-15 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
