| Entity Name: | EBENEZER MEDICAL GROUP INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 08 Feb 2021 (4 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 17 Dec 2021 (3 years ago) |
| Document Number: | P21000014445 |
| FEI/EIN Number | 86-2139931 |
| Address: | 2300 W 84 ST, SUITE 304, HIALEAH, FL 33016 |
| Mail Address: | 2300 W 84 ST, SUITE 304, HIALEAH, FL 33016 |
| ZIP code: | 33016 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487249645 | 2021-03-09 | 2021-03-09 | 2300 W 84TH ST STE 304, HIALEAH, FL, 330165773, US | 2300 W 84TH ST STE 304, HIALEAH, FL, 330165773, US | |||||||||||||||
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| Phone | +1 786-666-0590 |
| Fax | 7866660591 |
Authorized person
| Name | LEONEL TOMAS SANTOS RODRIGUEZ |
| Role | OWNER |
| Phone | 7867128252 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SANTOS RODRIGUEZ, LEONEL | Agent | 2300 W 84 ST, SUITE 304, HIALEAH, FL 33016 |
| Name | Role | Address |
|---|---|---|
| SANTOS RODRIGUEZ, LEONEL | President | 2300 W 84 ST, SUITE 304 HIALEAH, FL 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-12-17 | No data | No data |
| AMENDMENT | 2021-06-23 | No data | No data |
| AMENDMENT | 2021-03-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-04 | 2300 W 84 ST, SUITE 304, HIALEAH, FL 33016 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-04 | 2300 W 84 ST, SUITE 304, HIALEAH, FL 33016 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-26 |
| Amendment | 2021-12-17 |
| Amendment | 2021-06-23 |
| Amendment | 2021-03-04 |
| Domestic Profit | 2021-02-08 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
