| Entity Name: | CUELLO MEDICAL GROUP INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Aug 2018 (6 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P18000071210 |
| FEI/EIN Number | 83-1632330 |
| Address: | 2921 SW 8TH ST, MIAMI, FL, 33135, US |
| Mail Address: | 2921 sw 8 st, MIAMI, FL, 33135, US |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104307370 | 2018-08-27 | 2019-10-14 | 2921 SW 8TH ST, MIAMI, FL, 331352826, US | 10201 HAMMOCKS BLVD STE 123, MIAMI, FL, 331963783, US | |||||||||||||||||||||||
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| Phone | +1 305-532-9926 |
| Fax | 3055702060 |
| Phone | +1 305-279-7020 |
| Fax | 3055988089 |
Authorized person
| Name | STEPHANY GUZMAN |
| Role | BILLING DIRECTOR |
| Phone | 3055329926 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME00449683 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CUELLO MEDICAL GROUP INC 401 K PROFIT SHARING PLAN TRUST | 2018 | 831632330 | 2019-04-16 | CUELLO MEDICAL GROUP INC | 8 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2019-04-16 |
| Name of individual signing | ESTHER ENCINOSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| cuello cesar | Agent | 2921 sw 8 st, MIAMI, FL, 33135 |
| Name | Role | Address |
|---|---|---|
| CUELLO CESAR | President | 2921 SW 8TH ST, MIAMI, FL, 33135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-30 | 2921 SW 8TH ST, MIAMI, FL 33135 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-30 | 2921 sw 8 st, MIAMI, FL 33135 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-06-30 | cuello, cesar | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-28 | 2921 SW 8TH ST, MIAMI, FL 33135 | No data |
| AMENDMENT | 2018-10-29 | No data | No data |
| AMENDMENT | 2018-09-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-30 |
| AMENDED ANNUAL REPORT | 2019-09-03 |
| ANNUAL REPORT | 2019-02-28 |
| Amendment | 2018-10-29 |
| Amendment | 2018-09-07 |
| Domestic Profit | 2018-08-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
