| Entity Name: | NATALIA VALDERRAMA, DDS, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Mar 2014 (11 years ago) |
| Document Number: | P14000019298 |
| FEI/EIN Number | 46-5014499 |
| Address: | 903 Jordan Blass Dr, MELBOURNE, FL, 32940, US |
| Mail Address: | 976 Wildwood Drive, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861877102 | 2015-07-28 | 2015-07-28 | 976 WILDWOOD DR, MELBOURNE, FL, 329401506, US | 903 JORDAN BLASS DR STE 102, MELBOURNE, FL, 329401325, US | |||||||||||||||||||||||||||
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| Phone | +1 904-434-7783 |
| Phone | +1 321-544-4127 |
Authorized person
| Name | DR. NATALIA VALDERRAMA DOUGHERTY |
| Role | PRESIDENT/OWNER |
| Phone | 9044347783 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| License Number | DN19651 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | DN19651 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| VALDERRAMA NATALIA Dr. | Agent | 976 Wildwood Drive, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| VALDERRAMA NATALIA Dr. | President | 976 WILDWOOD DRIVE, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| VALDERRAMA NATALIA Dr. | Director | 976 WILDWOOD DRIVE, MELBOURNE, FL, 32940 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000064146 | VALDERRAMA ORTHODONTICS | ACTIVE | 2015-06-21 | 2025-12-31 | No data | 976 WILDWOOD DRIVE, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-31 | 903 Jordan Blass Dr, Suite 102, MELBOURNE, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-12 | 903 Jordan Blass Dr, Suite 102, MELBOURNE, FL 32940 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-02-12 | VALDERRAMA, NATALIA, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-12 | 976 Wildwood Drive, MELBOURNE, FL 32940 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-02-12 |
| AMENDED ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2017-01-06 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
