| Entity Name: | MYRIAM TAVERAS, D.M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 15 Aug 2016 (9 years ago) |
| Document Number: | P16000067703 |
| FEI/EIN Number | 81-3590389 |
| Address: | 15810 West State Road 84, Sunrise, FL 33326 |
| Mail Address: | 15810 West State Road 84, Sunrise, FL 33326 |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467086272 | 2020-03-02 | 2020-03-02 | 15810 WEST SR 84, SUNRISE, FL, 33326, US | 15810 WEST SR 84, SUNRISE, FL, 33326, US | |||||||||||||||||||
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| Phone | +1 954-389-9600 |
Authorized person
| Name | MYRIAM TAVERAS |
| Role | DENTIST |
| Phone | 4076926633 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | 1598190852 |
| Number | 1598190852 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TAVERAS, MYRIAM | Agent | 15810 West State Road 84, Sunrise, FL 33326 |
| Name | Role | Address |
|---|---|---|
| TAVERAS, MYRIAM | President | 15810 West State Road 84, Sunrise, FL 33326 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-16 | 15810 West State Road 84, Sunrise, FL 33326 | No data |
| CHANGE OF MAILING ADDRESS | 2020-01-16 | 15810 West State Road 84, Sunrise, FL 33326 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-16 | 15810 West State Road 84, Sunrise, FL 33326 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-04-28 |
| Domestic Profit | 2016-08-15 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
