| Entity Name: | JOSE ERNESTO BETANCOURT DIAZ MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Nov 2020 (4 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Jan 2025 (a month ago) |
| Document Number: | P20000094030 |
| FEI/EIN Number | 86-1391512 |
| Address: | 18063 NW 87th PL, Miami, FL, 33018, US |
| Mail Address: | 18063 NW 87TH PL, MIAMI, FL, 33018, US |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447840947 | 2021-01-19 | 2022-05-01 | 601 N FLAMINGO RD STE 306, PEMBROKE PINES, FL, 330281010, US | 601 N FLAMINGO RD STE 306, PEMBROKE PINES, FL, 330281010, US | |||||||||||||||||||
|
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| Phone | +1 786-363-8587 |
| Fax | 7863638587 |
Authorized person
| Name | JOSE ERNESTO BETANCOURT |
| Role | PRESIDENT |
| Phone | 7863638587 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RC0001X - Clinical Cardiac Electrophysiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BETANCOURT JOSE E | Agent | 18063 NW 87TH PL, MIAMI, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| BETANCOURT JOSE E | President | 18063 NW 87th PL, Miami, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| Ruiz Kyrene | Vice President | 18063 NW 87th PL, Miami, FL, 33018 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000034242 | CARDIOLOGY ELECTROPHYSIOLOGY CLINIC | ACTIVE | 2022-03-14 | 2027-12-31 | No data | 601 N FLAMINGO ROAD SUITE 306, PEMBROKE PINES, FL, 33028 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-26 | 18063 NW 87th PL, Miami, FL 33018 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-03-14 | BETANCOURT, JOSE ERNESTO | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2025-01-02 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-03-12 |
| Domestic Profit | 2020-11-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
