| Entity Name: | JORGE LOPEZ-CANINO, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Aug 2015 (9 years ago) |
| Document Number: | P15000068852 |
| FEI/EIN Number | 47-4849180 |
| Address: | 15495 Eagle Nest Lane, Suite 245, Miami Lakes, FL, 33014, US |
| Mail Address: | 15495 Eagle Nest Lane, Suite 245, Miami Lakes, FL, 33014, US |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467803411 | 2016-06-30 | 2020-06-06 | 16021 NW 79TH CT, MIAMI LAKES, FL, 330166644, US | 15495 EAGLE NEST LN STE 245, MIAMI LAKES, FL, 33014, US | |||||||||||||||||||
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| Phone | +1 305-330-6692 |
| Fax | 3053306686 |
Authorized person
| Name | ANA LOPEZCANINO |
| Role | OFFICE MANAGER |
| Phone | 3053306692 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME123509 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LOPEZ-CANINO JORGE | Agent | 15495 Eagle Nest Lane, Miami Lakes, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| Lopez-Canino Jorge | President | Ste 245, Miami Lakes, FL, 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-05-08 | 15495 Eagle Nest Lane, Suite 245, Miami Lakes, FL 33014 | No data |
| CHANGE OF MAILING ADDRESS | 2019-05-08 | 15495 Eagle Nest Lane, Suite 245, Miami Lakes, FL 33014 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-05-08 | 15495 Eagle Nest Lane, Suite 245, Miami Lakes, FL 33014 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-13 |
| ANNUAL REPORT | 2022-05-07 |
| ANNUAL REPORT | 2021-03-31 |
| ANNUAL REPORT | 2020-06-06 |
| ANNUAL REPORT | 2019-05-08 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-02-11 |
| ANNUAL REPORT | 2016-09-06 |
| Domestic Profit | 2015-08-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
