| Entity Name: | GUSTAVO G. LEON MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 30 Aug 2022 (2 years ago) |
| Document Number: | P22000067729 |
| FEI/EIN Number | 88-4018164 |
| Address: | 7481 MILLER DRIVE, MIAMI, FL 33155 |
| Mail Address: | 7481 MILLER DRIVE, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235850272 | 2022-09-08 | 2022-09-08 | 7481 MILLER DR, MIAMI, FL, 331555505, US | 2525 SW 75TH AVE, MIAMI, FL, 331552800, US | |||||||||||||
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| Phone | +1 305-260-1842 |
Authorized person
| Name | GUSTAVO LEON |
| Role | OWNER |
| Phone | 3053329013 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GUSTAVO G. LEON | Agent | 7481 MILLER DRIVE, MIAMI, FL 33155 |
| Name | Role | Address |
|---|---|---|
| GUSTAVO G. LEON | President | 7481 MILLER DRIVE, MIAMI, FL 33155 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-28 |
| ANNUAL REPORT | 2023-02-26 |
| Domestic Profit | 2022-08-30 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
