| Entity Name: | GIANA MEDICAL CENTER CLINICA HISPANA CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 01 May 2020 (5 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 24 Jun 2021 (4 years ago) |
| Document Number: | P20000032839 |
| FEI/EIN Number | 85-0959103 |
| Address: | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 |
| Mail Address: | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 |
| ZIP code: | 33903 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194340018 | 2020-06-16 | 2024-09-19 | 13240 N CLEVELAND AVE STE 2&3, NORTH FORT MYERS, FL, 339034855, US | 13240 N CLEVELAND AVE STE 2-3, NORTH FORT MYERS, FL, 339034855, US | |||||||||||||||||||||
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| Phone | +1 239-599-4986 |
| Fax | 2392056101 |
Authorized person
| Name | MRS. ANA IVIS CABRERA GONZALEZ |
| Role | PRESIDENT |
| Phone | 2395994986 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 108349200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CABRERA GONZALEZ, ANA IVIS | Agent | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 |
| Name | Role | Address |
|---|---|---|
| CABRERA GONZALEZ, ANA IVIS | President | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-04-13 | CABRERA GONZALEZ, ANA IVIS | No data |
| AMENDMENT | 2021-06-24 | No data | No data |
| AMENDMENT | 2020-10-05 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-07-15 | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-07-15 | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 | No data |
| AMENDMENT | 2020-07-15 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-07-15 | 13240 N. CLEVELAND AVE - STE. 2 & 3, NORTH FT. MYERS, FL 33903 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-04-13 |
| Off/Dir Resignation | 2021-06-24 |
| Amendment | 2021-06-24 |
| ANNUAL REPORT | 2021-03-10 |
| Amendment | 2020-10-05 |
| Amendment | 2020-07-15 |
| Domestic Profit | 2020-05-01 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
