| Entity Name: | SOUTHEAST PHYSICIAN ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 16 May 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: | P14000044140 |
| Address: | 10621 N. KENDALL DRIVE, 211, MIAMI, FL 33176 |
| Mail Address: | 10621 N. KENDALL DRIVE, 211, MIAMI, FL 33176 |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750793907 | 2014-05-22 | 2014-05-22 | 10621 N KENDALL DR, SUITE 211, MIAMI, FL, 331768708, US | 10621 N KENDALL DR, SUITE 211, MIAMI, FL, 331768708, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 305-458-1475 |
| Fax | 3054242054 |
Authorized person
| Name | MR. RENE F GOMEZ |
| Role | PRESIDENT |
| Phone | 3054581475 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COHEN, GERALD M | Agent | 12131 SW 68TH CT., PINECREST, FL 33156 |
| Name | Role | Address |
|---|---|---|
| GOMEZ, RENE | President | 10621 N. KENDALL DRIVE, STE 211, MIAMI, FL 33176 |
| Name | Role | Address |
|---|---|---|
| WARDLOW, CHARLES | Vice President | 10621 N. KENDALL DRIVE, STE 211, MIAMI, FL 33176 |
| Name | Role | Address |
|---|---|---|
| GOMEZ, RENE | Treasurer | 10621 N. KENDALL DRIVE, STE 211, MIAMI, F 33176 |
| Name | Role | Address |
|---|---|---|
| WARDLOW, CHARLES | Secretary | 10621 N. KENDALL DRIVE, STE 211, MIAMI, FL 33156 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2014-05-16 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
