| Entity Name: | PARADISE LAKES FAMILY DENTIST INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Jan 2016 (9 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P16000005442 |
| FEI/EIN Number | 811175277 |
| Address: | 16830 N KENDALL DR, MIAMI, FL, 33196, US |
| Mail Address: | 16830 N KENDALL DR, MIAMI, FL, 33196, US |
| ZIP code: | 33196 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215395116 | 2016-02-05 | 2016-02-05 | 16830 N KENDALL DR, MIAMI, FL, 331965935, US | 16830 N KENDALL DR, MIAMI, FL, 331965935, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-388-4886 |
| Fax | 3053889880 |
Authorized person
| Name | DR. ALFREDO DOMINGO CORPAS |
| Role | DENTIST/OWNER |
| Phone | 3053884886 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN0013451 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 074855203 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORPAS ALFREDO D | Agent | 16830 N KENDALL DR, MIAMI, FL, 33196 |
| Name | Role | Address |
|---|---|---|
| CORPAS ALFREDO D | Director | 16830 N KENDALL DR, MIAMI, FL, 33196 |
| CORPAS MARLENE V | Director | 16830 N KENDALL DR, MIAMI, FL, 33196 |
| Name | Role | Address |
|---|---|---|
| CORPAS ALFREDO D | President | 16830 N KENDALL DR, MIAMI, FL, 33196 |
| Name | Role | Address |
|---|---|---|
| CORPAS ALFREDO D | Treasurer | 16830 N KENDALL DR, MIAMI, FL, 33196 |
| Name | Role | Address |
|---|---|---|
| CORPAS MARLENE V | Vice President | 16830 N KENDALL DR, MIAMI, FL, 33196 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-04-03 |
| Domestic Profit | 2016-01-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
