| Entity Name: | JCL ORAL SURGERY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Mar 2021 (4 years ago) |
| Document Number: | P21000022789 |
| FEI/EIN Number | 86-2648644 |
| Address: | 11020 SW 88 ST, Miami, FL, 33176, US |
| Mail Address: | 11020 SW 88 ST, Miami, FL, 33176, US |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609585066 | 2022-11-15 | 2022-11-15 | 11020 SW 88TH ST STE 106, MIAMI, FL, 331761217, US | 11020 SW 88TH ST STE 106, MIAMI, FL, 331761217, US | |||||||||||||||||||
|
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| Phone | +1 305-279-8600 |
Authorized person
| Name | DR. JUAN CARLOS LAZO |
| Role | PRESIDENT |
| Phone | 3052798600 |
Taxonomy
| Taxonomy Code | 204E00000X - Oral & Maxillofacial Surgery (D.M.D.) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | 1053705624 |
| Number | 1053705624 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAZO JUAN C | Agent | 11020 SW 88 ST, Miami, FL, 33176 |
| Name | Role | Address |
|---|---|---|
| LAZO JUAN C | President | 18111 NW 82ND CT, HIALEAH, FL, 33015 |
| Name | Role | Address |
|---|---|---|
| Lazo Lizandra | Manager | 11020 SW 88 ST, Miami, FL, 33176 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000027510 | SOUTH DADE ORAL AND MAXILLOFACIAL SURGERY | ACTIVE | 2023-02-28 | 2028-12-31 | No data | 11020 SW 88TH ST SUITE 106, MIAMI, FL, 33176 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-01 | 11020 SW 88 ST, Suite 106, Miami, FL 33176 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-01 | 11020 SW 88 ST, Suite 106, Miami, FL 33176 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-01 | 11020 SW 88 ST, Suite 106, Miami, FL 33176 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-02-10 |
| Domestic Profit | 2021-03-04 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
