| Entity Name: | DR. CLAUDIUS GALEN PROFESSIONAL THERAPY SERVICES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 May 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: | P10000040736 |
| Address: | 3140 NW 53 LANE, MIAMI, FL, 33142 |
| Mail Address: | 3140 NW 53 LANE, MIAMI, FL, 33142 |
| ZIP code: | 33142 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952602781 | 2010-11-10 | 2010-11-10 | 321 W 9TH ST, HIALEAH, FL, 330103853, US | 321 W 9TH ST, HIALEAH, FL, 330103853, US | |||||||||||||||||||||||||||||
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| Phone | +1 786-662-9188 |
Authorized person
| Name | MS. BARBARA MEDINA |
| Role | OWNER/PRESIDENT |
| Phone | 7866629188 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | OT 13096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001958200 |
| State | FL |
| Issuer | NATIONAL PROVIDER IDENTIFIER (NPI) |
| Number | 1700042595 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MEDINA BARBARA | Agent | 3140 NW 53 LANE, MIAMI, FL, 33142 |
| Name | Role | Address |
|---|---|---|
| MEDINA BARBARA | President | 3140 NW 53 LANE, MIAMI, FL, 33142 |
| Name | Role | Address |
|---|---|---|
| PEREZ ANA MARIA | Vice President | 3140 NW 53 LANE, MIAMI, FL, 33142 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2010-05-11 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
