| Entity Name: | ERNESTO FERNANDEZ, M.D. P.A.. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Apr 2010 (15 years ago) |
| Document Number: | P10000029993 |
| FEI/EIN Number | 800576148 |
| Address: | 3011 SW 112TH AVE, Miami, FL, 33165, US |
| Mail Address: | 3011 SW 112TH AVE, Miami, FL, 33165, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336470699 | 2010-01-26 | 2010-01-27 | 114 W. UNDERWOOD STREET, SUITE A, ORLANDO, FL, 328061112, US | 114 W. UNDERWOOD STREET, SUITE A, ORLANDO, FL, 328061112, US | |||||||||||||||||||||||||
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| Phone | +1 407-423-3344 |
| Fax | 4074237785 |
Authorized person
| Name | DR. ERNESTO FERNANDEZ |
| Role | DOCTOR/CARDIOLOGIST |
| Phone | 4074233344 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME0027387 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 038285000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ ERNESTO | Agent | 3011 SW 112TH AVE, Miami, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ ERNESTO | President | 3011 SW 112TH AVE, Miami, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-24 | 3011 SW 112TH AVE, Miami, FL 33165 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-24 | 3011 SW 112TH AVE, Miami, FL 33165 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-24 | 3011 SW 112TH AVE, Miami, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-04-02 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-06-24 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-02-22 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
