| Entity Name: | LISETTE PORTES MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Sep 2020 (4 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 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720750631 | 2021-09-29 | 2021-09-29 | 3115 SW 98TH CT, MIAMI, FL, 331652954, US | 9995 SW 72ND ST STE 202, MIAMI, FL, 331734662, US | |||||||||||||||
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| Phone | +1 305-332-9821 |
| Fax | 3053564048 |
Authorized person
| Name | DR. LISETTE PORTES |
| Role | MEDICAL DIRECTOR |
| Phone | 3053329821 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PORTES LISETTE | Agent | 7171 Coral Way, Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| PORTES LISETTE | President | 3115 SW 98TH CT, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| PORTES LISETTE | Treasurer | 3115 SW 98TH CT, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| PORTES LISETTE | Secretary | 3115 SW 98TH CT, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-13 | 7171 Coral Way, Suite 500, Miami, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-13 | 7171 Coral Way, Suite 500, Miami, FL 33155 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-13 | 7171 Coral Way, Suite 500, Miami, FL 33155 | No data |
| 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 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
