| Entity Name: | PATIENT MEDICAL CENTER OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 18 Aug 2017 (7 years ago) |
| Date of dissolution: | 04 Dec 2024 (2 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 04 Dec 2024 (2 months ago) |
| Document Number: | P17000069809 |
| FEI/EIN Number | 82-3022425 |
| Address: | 7635 ASHLEY PARK CT, STE 503M, ORLANDO, FL 32835 |
| Mail Address: | 7635 ASHLEY PARK CT, STE 503M, ORLANDO, FL 32835 |
| ZIP code: | 32835 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891206504 | 2017-10-20 | 2018-07-05 | 819 N CENTRAL AVE, KISSIMMEE, FL, 347415027, US | 819 N CENTRAL AVE, KISSIMMEE, FL, 34741, US | |||||||||||||||||||||||||||||
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| Phone | +1 407-288-8242 |
| Fax | 4074901309 |
Authorized person
| Name | MR. LUIS MERCADO |
| Role | VICE PRESIDENT |
| Phone | 4072888242 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 023559900 |
| State | FL |
| Name | Role |
|---|---|
| J&E ACCOUNTING -TAX SOLUTIONS LLC | Agent |
| Name | Role | Address |
|---|---|---|
| PAGAN, ANGEL G | PRESIDENT | 27334 BONTERRA LP APT 303, WESLEY CHAPEL, FL 33544 |
| Name | Role | Address |
|---|---|---|
| MERCADO, LUIS | Chief Executive Officer | 7635 ASHLEY PARK CT, STE 503M ORLANDO, FL 32835 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-12-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-26 | 7635 ASHLEY PARK CT, STE 503M, ORLANDO, FL 32835 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-26 | 7635 ASHLEY PARK CT, STE 503M, ORLANDO, FL 32835 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-25 | J&E Accounting-Tax Solutions, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-25 | 7635 Ashley Park Court, Suite 503-M, Orlando, FL 32835 | No data |
| AMENDMENT | 2017-12-13 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-12-04 |
| ANNUAL REPORT | 2024-04-06 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-04-03 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-25 |
| Amendment | 2017-12-13 |
| Domestic Profit | 2017-08-18 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
