| Entity Name: | JESUS L JIMENEZ BARREDO MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Oct 2011 (13 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P11000086808 |
| FEI/EIN Number | 300700865 |
| Address: | 16520 NW 77TH PLACE, MIAMI LAKES, FL, 33016 |
| Mail Address: | 16520 NW 77TH PLACE, MIAMI LAKES, FL, 33016 |
| ZIP code: | 33016 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881970770 | 2011-10-24 | 2011-10-24 | 16520 NW 77TH PL, MIAMI LAKES, FL, 330163417, US | 16520 NW 77TH PL, MIAMI LAKES, FL, 330163417, US | |||||||||||||||||||||||||
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| Phone | +1 517-944-1914 |
| Fax | 7865584216 |
Authorized person
| Name | DR. JESUS L JIMENEZ BARREDO |
| Role | PRESIDENT |
| Phone | 5179441914 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| License Number | ME101359 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA LICENSE |
| Number | ME101359 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JIMENEZ BARREDO JESUS L | Agent | 16520 NW 77TH PLACE, MIAMI LAKES, FL, 33016 |
| Name | Role | Address |
|---|---|---|
| JIMENEZ BARREDO JESUS L | President | 16520 NW 77TH PLACE, MIAMI LAKES, FL, 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-02 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-02-27 |
| ANNUAL REPORT | 2015-04-11 |
| ANNUAL REPORT | 2014-01-15 |
| ANNUAL REPORT | 2013-04-03 |
| ANNUAL REPORT | 2012-04-04 |
| Domestic Profit | 2011-10-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
