| Entity Name: | DELGADO MEDICAL SERV CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Jan 2019 (6 years ago) |
| Document Number: | P19000007395 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 15251 SW 56 TERRACE, MIAMI, FL, 33193 |
| Mail Address: | PO BOX 960244, MIAMI, FL, 33296 |
| ZIP code: | 33193 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639637002 | 2019-03-05 | 2024-02-14 | PO BOX 960244, MIAMI, FL, 332960244, US | 15251 SW 56TH TER, MIAMI, FL, 331932502, US | |||||||||||||||||||
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| Phone | +1 786-760-5826 |
Authorized person
| Name | MISS SANDRA MONICA DELGADO |
| Role | NURSE PRACTITIONER |
| Phone | 7867605826 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101731600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DELGADO SANDRA MONICA | Agent | 15251 SW 56 TERRACE, MIAMI, FL, 33193 |
| Name | Role | Address |
|---|---|---|
| DELGADO SANDRA MONICA | President | 15251 SW 56 TERRACE, MIAMI, FL, 33193 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-02-06 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-03-09 |
| Domestic Profit | 2019-01-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
