| Entity Name: | NATALIA VILLATE M.D. P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 23 Jun 2014 (11 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P14000054337 |
| FEI/EIN Number | 47-1220324 |
| Address: | 4001 N. OCEAN DR, B704, BOCA RATON, FL 33431 |
| Mail Address: | 4001 N. OCEAN DR, B704, BOCA RATON, FL 33431 |
| ZIP code: | 33431 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275940124 | 2014-07-11 | 2014-07-11 | 4001 N OCEAN BLVD, APT B 704, BOCA RATON, FL, 334315363, US | 9980 CENTRAL PARK BLVD N, SUITE 204, BOCA RATON, FL, 334281762, US | |||||||||||||||||||||||||||
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| Phone | +1 561-245-8931 |
| Fax | 5614791680 |
| Phone | +1 305-788-0947 |
Authorized person
| Name | NATALIA VILLATE |
| Role | PRESIDENT |
| Phone | 3057880947 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | ME102239 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 466500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STRAUSS, KENNETH J | Agent | 515 EAST LAS OLAS BLVD, 15TH FL, FORT LAUDERDALE, FL 33301 |
| Name | Role | Address |
|---|---|---|
| VILLATE, NATALIA | President | 4001 N. OCEAN DR. B704, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| VILLATE, NATALIA | Secretary | 4001 N. OCEAN DR. B704, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| SUAREZ, MARIO | Vice President | 4001 N. OCEAN DR. B704, BOCA RATON, FL 33431 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| NAME CHANGE AMENDMENT | 2014-07-07 | NATALIA VILLATE M.D. P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-01 |
| ANNUAL REPORT | 2015-01-19 |
| Name Change | 2014-07-07 |
| Domestic Profit | 2014-06-23 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
