| Entity Name: | ROCHELIN MEDICAL P.C. CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Nov 2017 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Dec 2019 (5 years ago) |
| Document Number: | P17000094458 |
| FEI/EIN Number | 463501524 |
| Mail Address: | 4081 SW 139th Avenue, Hollywood, FL, 33027, US |
| Address: | 13571 Biscyane Blvd, North Miami Beach, FL, 33181, US |
| ZIP code: | 33181 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922433853 | 2013-09-11 | 2022-02-23 | 13571 BISCAYNE BLVD, NORTH MIAMI BEACH, FL, 331811630, US | 13571 BISCAYNE BLVD, NORTH MIAMI BEACH, FL, 331811630, US | |||||||||||||||||||||||||
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| Phone | +1 305-974-5548 |
| Fax | 8663701485 |
Authorized person
| Name | FLEURGIN ROCHELIN |
| Role | DIRECTOR |
| Phone | 6468969170 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 259771 |
| State | NY |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 03441196 |
| State | NY |
| Name | Role | Address |
|---|---|---|
| ROCHELIN FLEURGIN | Agent | 4081 SW 139th Avenue, Hollywood, FL, 33027 |
| Name | Role | Address |
|---|---|---|
| ROCHELIN FLEURGIN | Director | 90 SW 3rd Street, miami, FL, 33130 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-05-08 | 13571 Biscyane Blvd, North Miami Beach, FL 33181 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-08 | 4081 SW 139th Avenue, 2511, Hollywood, FL 33027 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-14 | 13571 Biscyane Blvd, North Miami Beach, FL 33181 | No data |
| REINSTATEMENT | 2019-12-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-12-23 | ROCHELIN, FLEURGIN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-05-08 |
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-11 |
| REINSTATEMENT | 2019-12-23 |
| Domestic Profit | 2017-11-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
