| Entity Name: | SU FAMILIA MEDICAL CENTER INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 03 Mar 2014 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P14000019454 |
| Address: | 7811 S.W. 24 STREET, 105, MIAMI, FL 33155 |
| Mail Address: | 7811 S.W. 24 STREET, 105, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144634726 | 2014-06-11 | 2014-06-11 | 7811 SW 24TH ST, 105, MIAMI, FL, 331556540, US | 7811 SW 24TH ST, 105, MIAMI, FL, 331556540, US | |||||||||||||||||||||||||
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| Phone | +1 305-318-0121 |
| Fax | 3056752668 |
Authorized person
| Name | ZOAR RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 3053180121 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC10090 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA HCC UNIT |
| Number | FILE 10704 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, ZOAR | Agent | 7811 S.W. 24 STREET, 105, MIAMI, FL 33155 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, ZOAR | President | 7811 S.W. 24 STREET #105, MIAMI, FL 33155 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, RONALD | Vice President | 7811 S.W. 24 STREET # 105, MIAMI, FL 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2014-03-03 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
