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GUILLERMO VALENZUELA, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: GUILLERMO VALENZUELA, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 19 Apr 2012 (13 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 18 Nov 2022 (3 years ago)
Document Number: P12000037083
FEI/EIN Number 80-0808192
Address: 140 SW 84TH AVENUE, B, PLANTATION, FL, 33324, US
Mail Address: 140 SW 84TH AVENUE, B, PLANTATION, FL, 33324, US
ZIP code: 33324
City: Fort Lauderdale
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
GUILLERMO VALENZUELA MD PA Agent 140 SW 84TH AVENUE, PLANTATION, FL, 33324
VALENZUELA GUILLERMO M President 140 SW 84TH AVENUE, PLANTATION, FL, 33324
Cacopardo Ilaria Officer 140 SW 84TH AVENUE, PLANTATION, FL, 33324

National Provider Identifier

NPI Number:
1740549260
Certification Date:
2024-02-20

Authorized Person:

Name:
GUILLERMO VALENZUELA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
332900000X - Non-Pharmacy Dispensing Site
Is Primary:
No
Selected Taxonomy:
207RR0500X - Rheumatology Physician
Is Primary:
Yes

Contacts:

Fax:
9544765695

Form 5500 Series

Employer Identification Number (EIN):
800808192
Plan Year:
2024
Number Of Participants:
38
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
30
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
20
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000025100 INTEGRAL RHEUMATOLOGY & IMMUNOLOGY SPECIALISTS ACTIVE 2021-02-23 2026-12-31 - 140 SW 84 AVENUE, UNIT B, PLANTATION, FL, 33324
G12000046587 INTEGRAL RHEUMATOLOGY & IMMUNOLOGY SPECIALISTS EXPIRED 2012-05-18 2017-12-31 - 140 SW 84TH AVENUE, SUITE B, PLANTATION, FL, 33324

Events

Event Type Filed Date Value Description
REINSTATEMENT 2022-11-18 - -
REGISTERED AGENT NAME CHANGED 2022-11-18 GUILLERMO VALENZUELA MD PA -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -

Documents

Name Date
ANNUAL REPORT 2025-02-10
ANNUAL REPORT 2024-02-04
ANNUAL REPORT 2023-04-10
REINSTATEMENT 2022-11-18
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-03-19
ANNUAL REPORT 2019-02-08
ANNUAL REPORT 2018-03-05
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-03-08

Paycheck Protection Program

Jobs Reported:
20
Initial Approval Amount:
$272,470
Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$272,470
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$276,428.38
Servicing Lender:
First Horizon Bank
Use of Proceeds:
Payroll: $272,470

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Date of last update: 01 Aug 2025

Sources: Florida Department of State