| Entity Name: | CORAL GABLES VISTA DENTISTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Aug 2023 (a year ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 20 Nov 2023 (a year ago) |
| Document Number: | P23000059089 |
| FEI/EIN Number | 93-2876673 |
| Address: | 7171 CORAL WAY, SUITE 217, MIAMI, FL, 33155, US |
| Mail Address: | 7171 CORAL WAY, SUITE 217, MIAMI, FL, 33155, US |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730963398 | 2023-08-23 | 2023-08-23 | 6891 SW 51ST ST, MIAMI, FL, 331555707, US | 7171 CORAL WAY STE 217, MIAMI, FL, 331551691, US | |||||||||||||
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| Phone | +1 305-305-5830 |
Authorized person
| Name | DR. VANESSA DE LA BARCA DOMINGUEZ |
| Role | DENTIST |
| Phone | 3053055830 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| STESZEWSKI JONATHAN ESQ | Agent | 15100 NW 7 AVE STE 200, MIAMI LAKES, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ CARDOSO ALIEN | President | 14562 SW 142 COURT CIRCLE, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| DE LA BARCA VANESSA | Vice President | 6891 SW 51 STREET, MIAMI, FL, 33155 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000112384 | GABLES VISTA DENTISTRY | ACTIVE | 2023-09-13 | 2028-12-31 | No data | 7171 CORAL WAY,SUITE 217, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-11-20 | No data | No data |
| AMENDMENT | 2023-09-13 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-09-13 | 7171 CORAL WAY, SUITE 217, MIAMI, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-13 | 7171 CORAL WAY, SUITE 217, MIAMI, FL 33155 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| Amendment | 2023-11-20 |
| Amendment | 2023-09-13 |
| Domestic Profit | 2023-08-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
