| Entity Name: | GREEN MOUNTAIN MED CON INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Apr 2019 (6 years ago) |
| Document Number: | P19000036367 |
| FEI/EIN Number | 83-4636071 |
| Address: | 7925 NW 12 ST, Doral, FL, 33126, US |
| Mail Address: | 7925 NW 12 ST, Doral, FL, 33126, US |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194330340 | 2020-09-14 | 2022-10-13 | 7925 NW 12TH ST STE 325, DORAL, FL, 331261846, US | 7925 NW 12TH ST STE 325, DORAL, FL, 331261846, US | |||||||||||||||||||||||||
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| Phone | +1 786-580-4957 |
| Fax | 7867735259 |
| Phone | +1 786-571-2788 |
Authorized person
| Name | CLAUDIA FUNDORA |
| Role | PRESIDENT |
| Phone | 7865712788 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FUNDORA CLAUDIA | Agent | 15981 SW 54TH TER, MIAMI, FL, 33185 |
| Name | Role | Address |
|---|---|---|
| FUNDORA CLAUDIA | President | 15981 SW 54TER, MIAMI, FL, 33185 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-22 | 15981 SW 54TH TER, MIAMI, FL 33185 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-28 | 7925 NW 12 ST, SUITE 325, Doral, FL 33126 | No data |
| CHANGE OF MAILING ADDRESS | 2022-09-28 | 7925 NW 12 ST, SUITE 325, Doral, FL 33126 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-04-04 |
| Domestic Profit | 2019-04-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
