| Entity Name: | RAFAEL ANGEL GONZALEZ MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Sep 2024 (5 months ago) |
| Document Number: | P24000057549 |
| Address: | 9940 SW 62 ST, MIAMI, FL 33173 |
| Mail Address: | 9940 SW 62 ST, MIAMI, FL 33173 |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942029533 | 2024-10-09 | 2024-10-11 | 7150 W 20TH AVE STE 412E, HIALEAH, FL, 330165533, US | 7150 W 20TH AVE STE 615, HIALEAH, FL, 330165511, US | |||||||||||||||
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| Phone | +1 305-702-9441 |
| Fax | 3057029442 |
Authorized person
| Name | DR. RAFAEL A GONZALEZ |
| Role | PHYSICIAN |
| Phone | 3057029441 |
Taxonomy
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, RAFAEL A | Agent | 9940 SW 62 ST, MIAMI, FL 33173 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, RAFAEL A | President | 9940 SW 62 ST, MIAMI, FL 33173 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-09-06 |
Date of last update: 06 Jan 2025
Sources: Florida Department of State
