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EBENEZER MEDICAL CENTER ORLANDO CORP. - Florida Company Profile

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Company Details

Entity Name: EBENEZER MEDICAL CENTER ORLANDO CORP.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 24 Mar 2022 (3 years ago)
Document Number: P22000022124
FEI/EIN Number 881444680
Address: 14308 SW 165TH ST, MIAMI, FL, 33177, US
Mail Address: 845 E OAK ST, kissimmee, FL, 34744, US
ZIP code: 33177
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
JIMENEZ MAITE President 14308 SW 165 ST, MIAMI, FL, 33177
FERNANDEZ SANCHEZ DAYMA Vice President 9000 SW 24TH ST, MIAMI, FL, 33165
JIMENEZ MAITE Agent 14308 SW 165 ST, MIAMI, FL, 33177

National Provider Identifier

NPI Number:
1265178131
Certification Date:
2023-01-18

Authorized Person:

Name:
MAITE JIMENEZ
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
8884983604

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-09-27 14308 SW 165TH ST, MIAMI, FL 33177 -
CHANGE OF MAILING ADDRESS 2022-09-26 14308 SW 165TH ST, MIAMI, FL 33177 -

Documents

Name Date
ANNUAL REPORT 2025-02-09
ANNUAL REPORT 2024-04-25
ANNUAL REPORT 2023-04-30
Domestic Profit 2022-03-24

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Date of last update: 02 Aug 2025

Sources: Florida Department of State