| Entity Name: | MI TIERRA MEDICAL GROUP CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Jun 2021 (4 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 03 Nov 2023 (a year ago) |
| Document Number: | P21000053107 |
| FEI/EIN Number | 87-1047858 |
| Address: | 14221 SW 120TH ST, SUITE 221, MIAMI, FL 33186 |
| Mail Address: | 14221 SW 120TH ST, SUITE 221, MIAMI, FL 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790455053 | 2021-09-17 | 2024-04-19 | 14221 SW 120TH ST STE 221, MIAMI, FL, 331864225, US | 14221 SW 120TH ST STE 221, MIAMI, FL, 331864225, US | |||||||||||||||||||||||||
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| Phone | +1 786-238-7492 |
| Fax | 7862387426 |
| Fax | 7866902296 |
Authorized person
| Name | JOAN RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 7862383054 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, JOAN | Agent | 12728 SW 64 TER, MIAMI, FL 33183 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, JOAN | President | 12728 SW 64 TER, MIAMI, FL 33183 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-11-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-08-01 | 14221 SW 120TH ST, SUITE 221, MIAMI, FL 33186 | No data |
| CHANGE OF MAILING ADDRESS | 2023-08-01 | 14221 SW 120TH ST, SUITE 221, MIAMI, FL 33186 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-08-01 | RODRIGUEZ, JOAN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-08-01 | 12728 SW 64 TER, MIAMI, FL 33183 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| Amendment | 2023-11-03 |
| ANNUAL REPORT | 2023-08-01 |
| ANNUAL REPORT | 2022-02-23 |
| Domestic Profit | 2021-06-07 |
| Off/Dir Resignation | 2021-06-07 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
