| Entity Name: | C & V GABLES MEDICAL CENTER INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Jun 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P17000050453 |
| FEI/EIN Number | 82-1786672 |
| Address: | 470 BILTMORE WAY, STE 200 B, CORAL GABLES, FL, 33134, US |
| Mail Address: | 470 BILTMORE WAY, STE 200 B, CORAL GABLES, FL, 33134, US |
| ZIP code: | 33134 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679002109 | 2017-06-08 | 2022-07-21 | 470 BILTMORE WAY STE 200B, CORAL GABLES, FL, 331345788, US | 470 BILTMORE WAY STE 200B, CORAL GABLES, FL, 331345788, US | |||||||||||||||||||||||||
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| Phone | +1 305-445-5515 |
| Fax | 3054455518 |
Authorized person
| Name | CARLOS CANOVA DIAZ |
| Role | OWNER |
| Phone | 3054455515 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME104666 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021250000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARTINEZ XIOMARA | Agent | 470 BILTMORE WAY, CORAL GABLES, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| CANOVA DIAZ CARLOS | President | 3158 SW 110 AVE, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| AMENDMENT | 2017-06-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-12 |
| Amendment | 2017-06-14 |
| Domestic Profit | 2017-06-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
