| Entity Name: | LIDIANA SOSA CRUZ APRN PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 27 Apr 2020 (5 years ago) |
| Document Number: | P20000032073 |
| FEI/EIN Number | 85-1149659 |
| Address: | 9432 SW 155 AVE, MIAMI, FL 33196 |
| Mail Address: | 9432 SW 155 AVE, MIAMI, FL 33196 |
| ZIP code: | 33196 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417525940 | 2021-06-11 | 2021-06-11 | 9432 SW 155TH AVE, MIAMI, FL, 331961114, US | 9432 SW 155TH AVE, MIAMI, FL, 331961114, US | |||||||||||||
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| Phone | +1 305-801-4778 |
Authorized person
| Name | LIDIANA SOSA CRUZ |
| Role | PRESIDENT |
| Phone | 3058014778 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PORTO, LUIS L, JR | Agent | 9432 SW 155 AVE, MIAMI, FL 33196 |
| Name | Role | Address |
|---|---|---|
| SOSA CRUZ, LIDIANA | President | 9432 SW 155 AVE, MIAMI, FL 33196 |
| Name | Role | Address |
|---|---|---|
| PORTO, LUIS L, JR | Vice President | 9432 SW 155 AVE, MIAMI, FL 33196 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-15 |
| Domestic Profit | 2020-04-27 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
