| Entity Name: | MEDISANA HEALTH CENTER CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Jul 2020 (5 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 May 2023 (2 years ago) |
| Document Number: | P20000052422 |
| FEI/EIN Number | 852037719 |
| Address: | 5391 NW 36 ST, MIAMI SPRINGS, FL, 33166, US |
| Mail Address: | 5391 NW 36 ST, MIAMI SPRINGS, FL, 33166, US |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952904195 | 2020-11-19 | 2023-11-02 | 5391 NW 36TH ST, MIAMI SPRINGS, FL, 331665924, US | 5391 NW 36TH ST, MIAMI SPRINGS, FL, 331665924, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 786-636-1310 |
| Fax | 7866361311 |
Authorized person
| Name | MS. GLEIDYS SOTO ALONSO |
| Role | OWNER |
| Phone | 3057993112 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109165700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SOTO GLEIDYS | Agent | 5391 NW 36 ST, MIAMI SPRINGS, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| MACEDA HERNANDEZ MADELINE | Vice President | 5391 NW 36 STREET, MIAMI SPRINGS, FL, 33166 |
| MADELINE MACEDA HERNANDEZ | Vice President | 5391 NW 36 ST, MIAMI SPRINGS, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| GLEIDYS SOTO ALONSO | President | 5391 NW 36 ST, MIAMI SPRINGS, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-06-05 | No data | No data |
| AMENDMENT | 2023-05-23 | No data | No data |
| AMENDMENT | 2020-12-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-12-23 | 5391 NW 36 ST, MIAMI SPRINGS, FL 33166 | No data |
| CHANGE OF MAILING ADDRESS | 2020-12-23 | 5391 NW 36 ST, MIAMI SPRINGS, FL 33166 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| Amendment | 2023-06-05 |
| Amendment | 2023-05-23 |
| AMENDED ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-07 |
| Amendment | 2020-12-23 |
| Domestic Profit | 2020-07-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
