| Entity Name: | WEST DADE PEDIATRICS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Jan 1993 (32 years ago) |
| Date of dissolution: | 31 Dec 2003 (21 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 31 Dec 2003 (21 years ago) |
| Document Number: | P93000003609 |
| FEI/EIN Number | 650380969 |
| Address: | 7100 W 20TH AVE, 608, HIALEAH, FL, 33016, US |
| Mail Address: | 7100 W 20TH AVE, 608, HIALEAH, FL, 33016, US |
| ZIP code: | 33016 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821392077 | 2011-01-03 | 2011-01-03 | 3220 SW 107TH AVE, MIAMI, FL, 331653606, US | 3220 SW 107TH AVE, MIAMI, FL, 331653606, US | |||||||||||||||||||||||||
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| Phone | +1 305-551-1195 |
| Fax | 3055511094 |
Authorized person
| Name | DR. JULIO C EGUSQUIZA |
| Role | MAG MEMBER |
| Phone | 3055511195 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME 54356 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 268809301 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EGUSQUIZA JOHN E | Agent | 3220 SW 107 AVE, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| EGUSQUIZA JULIO | President | 3220 SW. 107 AVE, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| EGUSQUIZA JULIO | Director | 3220 SW. 107 AVE, MIAMI, FL, 33165 |
| EGUSQUIZA MARIA V | Director | 2830 SW 130 AVE, MIAMI, FL, 33175 |
| Name | Role | Address |
|---|---|---|
| EGUSQUIZA MARIA V | Vice President | 2830 SW 130 AVE, MIAMI, FL, 33175 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2003-12-31 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS L02000032790. MERGER NUMBER 700000047647 |
| CHANGE OF PRINCIPAL ADDRESS | 2000-01-19 | 7100 W 20TH AVE, 608, HIALEAH, FL 33016 | No data |
| CHANGE OF MAILING ADDRESS | 2000-01-19 | 7100 W 20TH AVE, 608, HIALEAH, FL 33016 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2000-01-19 | 3220 SW 107 AVE, MIAMI, FL 33165 | No data |
| NAME CHANGE AMENDMENT | 1996-04-18 | WEST DADE PEDIATRICS, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2003-01-13 |
| ANNUAL REPORT | 2002-01-16 |
| ANNUAL REPORT | 2001-01-23 |
| ANNUAL REPORT | 2000-01-19 |
| ANNUAL REPORT | 1999-02-24 |
| ANNUAL REPORT | 1998-02-06 |
| ANNUAL REPORT | 1997-01-21 |
| ANNUAL REPORT | 1996-02-20 |
| ANNUAL REPORT | 1995-06-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
