| Entity Name: | SOUTH MIAMI SPORTS MEDICINE INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 Dec 2010 (14 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Nov 2012 (12 years ago) |
| Document Number: | P10000103919 |
| FEI/EIN Number | 30-0659575 |
| Address: | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| Mail Address: | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| ZIP code: | 33143 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013211705 | 2011-01-10 | 2011-01-10 | 7000 S.W. 62 AVENUE, SUITE 120, MIAMI, FL, 33143, US | 7000 SW 62ND AVE, SUITE 120, SOUTH MIAMI, FL, 331434716, US | |||||||||||||||||
|
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| Phone | +1 305-666-7168 |
Authorized person
| Name | MR. ROBERT A MILLARES |
| Role | PRESIDENT/OWNER |
| Phone | 3056667116 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| License Number | OT2468 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MILLARES, ROBERT | Agent | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| Name | Role | Address |
|---|---|---|
| MILLARES, ROBERT | Director | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| MILLARES, NANCY | Director | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| Name | Role | Address |
|---|---|---|
| MILLARES, ROBERT | President | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| Name | Role | Address |
|---|---|---|
| MILLARES, NANCY | Vice President | 7000 SW 62 AVENUE SUITE 120, MIAMI, FL 33143 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2012-11-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
