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LISETTE PORTES MD PA - Florida Company Profile

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Company Details

Entity Name: LISETTE PORTES MD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 08 Sep 2020 (5 years ago)
Document Number: P20000071944
FEI/EIN Number 85-3107254
Address: 7171 Coral Way, Miami, FL, 33155, US
Mail Address: 3115 SW 98TH CT, MIAMI, FL, 33165, US
ZIP code: 33155
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PORTES LISETTE President 3115 SW 98TH CT, MIAMI, FL, 33165
PORTES LISETTE Treasurer 3115 SW 98TH CT, MIAMI, FL, 33165
PORTES LISETTE Secretary 3115 SW 98TH CT, MIAMI, FL, 33165
PORTES LISETTE Agent 7171 Coral Way, Miami, FL, 33155

National Provider Identifier

NPI Number:
1720750631
Certification Date:
2021-09-29

Authorized Person:

Name:
DR. LISETTE PORTES
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3053564048

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-02-13 7171 Coral Way, Suite 500, Miami, FL 33155 -
CHANGE OF MAILING ADDRESS 2024-02-13 7171 Coral Way, Suite 500, Miami, FL 33155 -
REGISTERED AGENT ADDRESS CHANGED 2024-02-13 7171 Coral Way, Suite 500, Miami, FL 33155 -

Documents

Name Date
ANNUAL REPORT 2024-02-13
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-04-14
ANNUAL REPORT 2021-04-20
Domestic Profit 2020-09-08

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Date of last update: 02 Jul 2025

Sources: Florida Department of State