| Entity Name: | MEDICOR HEALTHCHOICE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Jun 1994 (31 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Oct 2024 (3 months ago) |
| Document Number: | P94000044236 |
| FEI/EIN Number | 65-0513852 |
| Mail Address: | P.O. BOX 226994, MIAMI, FL 33222 |
| Address: | 2200 NW 102ND AVE STE 2B, MIAMI, FL 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730189523 | 2005-07-22 | 2023-03-10 | 2200 NW 102 AVENUE SUITE 2B, DORAL, FL, 331722225, US | 2200 NW 102 AVENUE SUITE 2B, DORAL, FL, 331722225, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 800-250-4468 |
| Fax | 8886144949 |
Authorized person
| Name | MR. JACK A MARQUEZ |
| Role | VICE PRESIDENT |
| Phone | 8002504468 |
Taxonomy
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | HME051 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 682074300 |
| State | FL |
| Issuer | MEDICAID |
| Number | 951866500 |
| State | FL |
| Issuer | PHARMACY LICENSE |
| Number | PH26071 |
| State | FL |
| Issuer | AHCA |
| Number | HME051 |
| State | FL |
| Issuer | PHARMACY LICENSE |
| Number | PH26070 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALLEN DELL, PA | Agent | 202 S ROME AVE, TAMPA, FL 33606 |
| Name | Role | Address |
|---|---|---|
| MARQUEZ, JACK | Vice President | P.O. BOX 226994, MIAMI, FL 33222 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000034115 | COBRA PHARMACY + MEDICAL EQUIPMENT AND SUPPLIES | EXPIRED | 2012-04-10 | 2017-12-31 | No data | 10825 NW 17 STREET, SUITE 105, MIAMI, FL, 33172 |
| G12000003452 | COBRA MEDICAL EQUIPMENT PLUS PHARMACY | EXPIRED | 2012-01-10 | 2017-12-31 | No data | 10825 NW 17 STREET, SUITE 105, MIAMI, FL, 33172 |
| G11000063342 | COBRA MEDICAL | EXPIRED | 2011-06-23 | 2016-12-31 | No data | 2351 NW 93 AVENUE, DORAL, FL, 33172 |
| G11000062772 | COBRA MEDICAL SUPPLIES | EXPIRED | 2011-06-21 | 2016-12-31 | No data | 2351 NW 93 AVENUE, MIAMI, FL, 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-10-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-24 | 2200 NW 102ND AVE STE 2B, MIAMI, FL 33172 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-24 | 2200 NW 102ND AVE STE 2B, MIAMI, FL 33172 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-05-18 | 202 S ROME AVE, TAMPA, FL 33606 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-05-18 | ALLEN DELL, PA | No data |
| NAME CHANGE AMENDMENT | 2013-05-31 | MEDICOR HEALTHCHOICE, INC. | No data |
| AMENDMENT | 2013-05-30 | No data | No data |
| AMENDMENT | 1996-07-31 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-10-30 |
| AMENDED ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
