| Entity Name: | WELLEBY MEDICAL ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Dec 1993 (31 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P93000087247 |
| FEI/EIN Number | 650455431 |
| Address: | 7200 W. COMMERCIAL BLVD., 201, LAUDERHILL, FL, 33319, US |
| Mail Address: | 7200 W. COMMERCIAL BLVD., 201, LAUDERHILL, FL, 33319, US |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386719201 | 2006-11-24 | 2020-08-22 | 10028 W OAKLAND PARK BLVD, SUNRISE, FL, 333516959, US | 10028 W OAKLAND PARK BLVD, SUNRISE, FL, 333516959, US | |||||||||||||||||||
|
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| Phone | +1 954-748-6665 |
| Fax | 9547460310 |
Authorized person
| Name | DR. LIBERTAD A PALMA |
| Role | MEDICAL DIRECTOR |
| Phone | 9547486665 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0027611 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FRIAL VICTOR | Agent | 7200 W. COMMERCIAL BLVD., LAUDERHILL, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| LOMANTO JOSEPHINE | Vice President | 7200 W. COMMERCIAL BLVD., LAUDERHILL, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| FRIAL VICTOR | Treasurer | 7200 W. COMMERCIAL BLVD., LAUDERHILL, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| PALMA JENNY | Secretary | 7200 W. COMMERCIAL BLVD., LAUDERHILL, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| PALMA, RICARDO | President | 7200 W. COMMERCIAL BLVD., LAUDERHILL, FL, 33319 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-19 | FRIAL, VICTOR | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-18 | 7200 W. COMMERCIAL BLVD., 201, LAUDERHILL, FL 33319 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-18 | 7200 W. COMMERCIAL BLVD., 201, LAUDERHILL, FL 33319 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-18 | 7200 W. COMMERCIAL BLVD., 201, LAUDERHILL, FL 33319 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-03-18 |
| ANNUAL REPORT | 2014-05-06 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-24 |
| ANNUAL REPORT | 2009-04-17 |
| ANNUAL REPORT | 2008-02-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
