| Entity Name: | RAFAEL DIAZ ACOSTA MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Aug 2016 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 18 Dec 2023 (a year ago) |
| Document Number: | P16000066459 |
| FEI/EIN Number | 81-3547013 |
| Address: | 4919 BILTMORE DR, MIAMI, FL, 33146, US |
| Mail Address: | 4919 BILTMORE DR, MIAMI, FL, 33146, US |
| ZIP code: | 33146 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902351083 | 2016-08-18 | 2024-09-13 | 10081 PINES BLVD STE B, PEMBROKE PINES, FL, 330246171, US | 3499 W 4TH AVE STE 201, HIALEAH, FL, 330124333, US | |||||||||||||||||||
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| Phone | +1 954-251-1175 |
| Phone | +1 305-558-0411 |
Authorized person
| Name | DR. RAFAEL DIAZ ACOSTA |
| Role | MD/OWNER |
| Phone | 8326066735 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME129046 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DIAZ ACOSTA RAFAEL | Agent | 4919 BILTMORE DR, MIAMI, FL, 33146 |
| Name | Role | Address |
|---|---|---|
| DIAZ ACOSTA RAFAEL | President | 4919 BILTMORE DR, MIAMI, FL, 33146 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-12-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-22 | 4919 BILTMORE DR, MIAMI, FL 33146 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-06 | 4919 BILTMORE DR, MIAMI, FL 33146 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-06 | 4919 BILTMORE DR, MIAMI, FL 33146 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-06 | DIAZ ACOSTA, RAFAEL | No data |
| REINSTATEMENT | 2020-10-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REINSTATEMENT | 2019-12-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| REINSTATEMENT | 2023-12-18 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-03-06 |
| REINSTATEMENT | 2020-10-29 |
| REINSTATEMENT | 2019-12-09 |
| ANNUAL REPORT | 2018-03-06 |
| AMENDED ANNUAL REPORT | 2017-10-10 |
| ANNUAL REPORT | 2017-04-24 |
| Domestic Profit | 2016-08-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
