| Entity Name: | LIFE BLUE MEDICAL CENTER, CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 17 Mar 2017 (8 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P17000025240 |
| FEI/EIN Number | 82-0879873 |
| Address: | 12260 SW 8 ST., STE. 230, MIAMI, FL 33184 |
| Mail Address: | 12260 SW 8 ST., STE. 230, MIAMI, FL 33184 |
| ZIP code: | 33184 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558898577 | 2017-05-22 | 2022-07-21 | 12260 SW 8TH ST STE 230, MIAMI, FL, 331841549, US | 12260 SW 8TH ST STE 230, MIAMI, FL, 331841549, US | |||||||||||||||||||
|
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| Phone | +1 305-456-5380 |
| Fax | 3056312638 |
Authorized person
| Name | MARIA C HERNANDEZ |
| Role | OWNER |
| Phone | 3054565380 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | HCC11034 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONZALEZ PEREZ, JORGE R | Agent | 12260 SW 8 ST., STE. 230, MIAMI, FL 33184 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ PEREZ, JORGE R | President | 12260 SW 8 ST., STE. 230, MIAMI, FL 33184 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| AMENDMENT | 2017-06-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-06-13 | GONZALEZ PEREZ, JORGE R | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-03-08 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-04-11 |
| Amendment | 2017-06-13 |
| Domestic Profit | 2017-03-17 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
