| Entity Name: | STAR MEDICAL CLINIC, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Jul 2010 (15 years ago) |
| Date of dissolution: | 23 Jul 2012 (13 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 23 Jul 2012 (13 years ago) |
| Document Number: | P10000057468 |
| FEI/EIN Number | 272909726 |
| Address: | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL, 33127 |
| Mail Address: | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL, 33127 |
| ZIP code: | 33127 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043525819 | 2010-08-17 | 2010-08-17 | 6112 NW 7TH AVE, MIAMI, FL, 331271112, US | 6112 NW 7TH AVE, MIAMI, FL, 331271112, US | |||||||||||||||||||||||
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| Phone | +1 786-360-2381 |
| Fax | 3054564066 |
Authorized person
| Name | MR. LARRY WHITFIELD JR. |
| Role | PRESDIENT (CEO) |
| Phone | 4438045364 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 269915000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARTIN GREGORY A | Agent | 1925 BRICKELL AVENUE, MIAMI, FL, 33129 |
| Name | Role | Address |
|---|---|---|
| WHITFIELD LARRY R | Vice President | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL, 33127 |
| Name | Role | Address |
|---|---|---|
| WHITFIELD LARRY R | President | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL, 33127 |
| Name | Role | Address |
|---|---|---|
| WHITFIELD LARRY R | Secretary | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL, 33127 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2012-07-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-22 | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL 33127 | No data |
| CHANGE OF MAILING ADDRESS | 2012-03-22 | 6112 NORTHWEST 7TH AVENUE, MIAMI, FL 33127 | No data |
| Name | Date |
|---|---|
| CORAPVDWN | 2012-07-23 |
| ANNUAL REPORT | 2012-03-22 |
| ANNUAL REPORT | 2011-04-30 |
| Domestic Profit | 2010-07-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
