| Entity Name: | MARIO A. JIMENEZ, MD. PA. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Jun 2013 (12 years ago) |
| Document Number: | P13000053480 |
| FEI/EIN Number | 46-3045357 |
| Address: | 14740 SW 26 Street, MIAMI, FL, 33185, US |
| Mail Address: | 12901 SW 66 Terr. Dr., Miami, FL, 33183, US |
| ZIP code: | 33185 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013357441 | 2013-06-29 | 2024-09-13 | 12901 SW 66TH TERRACE DR, MIAMI, FL, 331831315, US | 14740 SW 26TH ST STE 107, MIAMI, FL, 33185, US | |||||||||||||||||||
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| Phone | +1 305-388-1118 |
| Fax | 3052233242 |
Authorized person
| Name | MARIO A JIMENEZ |
| Role | OWNER |
| Phone | 3053881118 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME114414 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JIMENEZ MARIO A | Agent | 12901 SW 66 Terr. Dr., Miami, FL, 33183 |
| Name | Role | Address |
|---|---|---|
| JIMENEZ MARIO AMD | President | 12901 SW 66 Terr. Dr., Miami, FL, 33183 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-16 | 14740 SW 26 Street, MIAMI, FL 33185 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-20 | 14740 SW 26 Street, MIAMI, FL 33185 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-20 | 12901 SW 66 Terr. Dr., Miami, FL 33183 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-04-18 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
