| Entity Name: | LESTER DE LEON, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Nov 2011 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Feb 2018 (7 years ago) |
| Document Number: | P11000100342 |
| FEI/EIN Number | 453857644 |
| Address: | 4155 SW 136TH AVE, MIAMI, FL, 33175 |
| Mail Address: | 4155 SW 136TH AVE, MIAMI, FL, 33175 |
| ZIP code: | 33175 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164796090 | 2012-02-23 | 2012-02-23 | 4155 SW 136TH AVE, MIAMI, FL, 331753253, US | 4155 SW 136TH AVE, MIAMI, FL, 331753253, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 786-536-7614 |
Authorized person
| Name | LESTER DE LEON |
| Role | PRESIDENT |
| Phone | 7862595449 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME111208 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DE LEON LESTER M | Agent | 4155 SW 136TH AVE, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| DE LEON LESTER M | President | 4155 SW 136TH AVE, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| DE LEON LESTER M | Director | 4155 SW 136TH AVE, MIAMI, FL, 33175 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000003563 | DE LEON PRIMARY CARE | ACTIVE | 2022-01-10 | 2027-12-31 | No data | 4155 SW 136TH AVE, MIAMI, FL, 33175 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2018-02-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REINSTATEMENT | 2016-12-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-12-07 | DE LEON, LESTER M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-03-18 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-02-21 |
| ANNUAL REPORT | 2019-03-12 |
| REINSTATEMENT | 2018-02-26 |
| REINSTATEMENT | 2016-12-07 |
| ANNUAL REPORT | 2015-06-09 |
| ANNUAL REPORT | 2014-03-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
