| Entity Name: | MED DENTAL ASSOCIATES, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 Mar 2012 (13 years ago) |
| Document Number: | P12000028588 |
| FEI/EIN Number | 45-5481565 |
| Address: | 7200 NW 7 ST, SUITE 330, MIAMI, FL 33126 |
| Mail Address: | 7200 NW 7 ST, SUITE 330, MIAMI, FL 33126 |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801231444 | 2013-05-09 | 2013-05-09 | 7200 NW 7TH ST STE 333, MIAMI, FL, 331262955, US | 7200 NW 7TH ST STE 333, MIAMI, FL, 331262955, US | |||||||||||||||||||||||||
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| Phone | +1 305-264-0063 |
| Fax | 3052640065 |
Authorized person
| Name | ROXANA RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 9544372117 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | DN17094 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 076093500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROXANA, RODRIGUEZ | Agent | 4544 SW 195 WAY, MIRAMAR, FL 33029 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, ROXANA | President | 4544 SW 195 WAY, MIRAMAR, FL 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-23 | 7200 NW 7 ST, SUITE 330, MIAMI, FL 33126 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-23 | 7200 NW 7 ST, SUITE 330, MIAMI, FL 33126 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-09-19 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-04-15 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-11 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
