| Entity Name: | PEDIKIDZ OF FLORIDA, CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Apr 2017 (8 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 03 Jun 2019 (6 years ago) |
| Document Number: | P17000037916 |
| FEI/EIN Number | 82-1341364 |
| Address: | 9301 SW 56 ST STE C, MIAMI, FL, 33165, US |
| Mail Address: | 9301 SW 56 ST STE C, MIAMI, FL, 33165, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780349712 | 2021-11-04 | 2021-11-22 | 9301 SW 56TH ST STE C, MIAMI, FL, 331656559, US | 2311 10TH AVE N STE 12, LAKE WORTH, FL, 334616605, US | |||||||||||||||||||||||
|
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| Phone | +1 305-596-1088 |
Authorized person
| Name | REBECCA BELTRAN |
| Role | OWNER |
| Phone | 3055910188 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 024896100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BELTRAN REBECCA | Agent | 9301 SW 56 ST STE C, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| BELTRAN REBECCA | President | 9301 SW 56 ST STE C, MIAMI, FL, 33165 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000110427 | PEDIKIDZ OF FLORIDA THERAPY | EXPIRED | 2018-10-10 | 2023-12-31 | No data | 10250 SW 56 STREET SUITE C230, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-06-03 | 9301 SW 56 ST STE C, MIAMI, FL 33165 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-06-03 | BELTRAN, REBECCA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-06-03 | 9301 SW 56 ST STE C, MIAMI, FL 33165 | No data |
| AMENDMENT | 2019-06-03 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2019-06-03 | 9301 SW 56 ST STE C, MIAMI, FL 33165 | No data |
| AMENDMENT | 2018-05-29 | No data | No data |
| AMENDMENT | 2017-08-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-16 |
| Amendment | 2019-06-03 |
| ANNUAL REPORT | 2019-05-01 |
| Amendment | 2018-05-29 |
| ANNUAL REPORT | 2018-04-16 |
| Amendment | 2017-08-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
