| Entity Name: | KP MEDICAL CENTER, CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 18 Jan 2023 (2 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 17 Mar 2023 (2 years ago) |
| Document Number: | P23000005815 |
| FEI/EIN Number | 92-1993804 |
| Address: | 175 FONTAINEBLEAU BLVD, SUITE 1R, MIAMI, FL 33172 |
| Mail Address: | 175 FONTAINEBLEAU BLVD, SUITE 1R, MIAMI, FL 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245911353 | 2023-07-31 | 2023-07-31 | 175 FONTAINEBLEAU BLVD STE 1R, MIAMI, FL, 331724511, US | 175 FONTAINEBLEAU BLVD STE 1R, MIAMI, FL, 331724511, US | |||||||||||||||
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| Phone | +1 786-542-5173 |
| Fax | 7865362512 |
Authorized person
| Name | MR. KENIEL PENA |
| Role | PRESIDENT |
| Phone | 7863086024 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PENA, KENIEL | Agent | 175 FONTAINEBLEAU BLVD, SUITE 1R, MIAMI, FL 33172 |
| Name | Role | Address |
|---|---|---|
| PENA, KENIEL | President | 175 FONTAINEBLEAU BLVD SUITE 1R, MIAMI, FL 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-03-17 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-02 |
| ANNUAL REPORT | 2024-01-11 |
| Amendment | 2023-03-17 |
| Domestic Profit | 2023-01-18 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
