| Entity Name: | EVIDENCE BASE MEDICAL, CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 17 Jul 2015 (10 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P15000061147 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 900 PARK CENTRE BOULEVARD, SUITE 400, MIAMI GARDENS, FL 33169 |
| Mail Address: | 900 PARK CENTRE BLVD, SUITE # 400, MIAMI GARDEN, FL 33169 |
| ZIP code: | 33169 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700252624 | 2015-08-14 | 2015-08-14 | 5920 JOHNSON ST, SUITE 108, HOLLYWOOD, FL, 330215652, US | 5920 JOHNSON ST, SUITE 108, HOLLYWOOD, FL, 330215652, US | |||||||||||||
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| Phone | +1 954-967-4795 |
Authorized person
| Name | GONZALO GONZALEZ |
| Role | DIRECTOR |
| Phone | 9549674795 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, GONZALO | Agent | 5920 JOHNSON ST., SUITE #108, HOLLYWOOD, FL 33021 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, GONZALO | Director | 900 PARK CENTRE BOULEVARD, SUITE 400 MIAMI GARDENS, FL 33169 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-28 | 900 PARK CENTRE BOULEVARD, SUITE 400, MIAMI GARDENS, FL 33169 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-11-24 | 900 PARK CENTRE BOULEVARD, SUITE 400, MIAMI GARDENS, FL 33169 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-04-28 |
| Domestic Profit | 2015-07-17 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
