| Entity Name: | EVELYN MEDICAL CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jun 1994 (31 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P94000048879 |
| FEI/EIN Number | 650502636 |
| Address: | 1840 W. 49TH ST., STE. 227, HIALEAH, FL, 33012 |
| Mail Address: | 1840 W. 49TH ST., STE. 227, HIALEAH, FL, 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497874507 | 2007-03-28 | 2020-08-22 | 1840 W 49TH ST, SUITE 227, HIALEAH, FL, 330122942, US | 1840 W 49TH ST, SUITE 227, HIALEAH, FL, 330122942, US | |||||||||||||||||||||||||
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| Phone | +1 305-820-0095 |
| Fax | 3058200095 |
Authorized person
| Name | ERNESTO M CARRALERO |
| Role | PRESIDENT |
| Phone | 3058200095 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | HCC5602 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA HEALTH CARE CLINIC |
| Number | HCC5602 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARRALERO ERNESTO M | Agent | 1840 W. 49TH ST., STE. 227, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| CARRALERO ERNESTO M | President | 1840 W. 49TH ST., STE. 227, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| CARRALERO ERNESTO M | Director | 1840 W. 49TH ST., STE. 227, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-30 | 1840 W. 49TH ST., STE. 227, HIALEAH, FL 33012 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-03-06 | 1840 W. 49TH ST., STE. 227, HIALEAH, FL 33012 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-28 | CARRALERO, ERNESTO M | No data |
| AMENDMENT | 2005-10-13 | No data | No data |
| AMENDMENT | 2004-08-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-08-24 | 1840 W. 49TH ST., STE. 227, HIALEAH, FL 33012 | No data |
| REINSTATEMENT | 1997-12-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-29 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-03-06 |
| ANNUAL REPORT | 2007-04-28 |
| ANNUAL REPORT | 2006-04-28 |
| Amendment | 2005-10-13 |
| ANNUAL REPORT | 2005-04-28 |
| Amendment | 2004-08-24 |
| ANNUAL REPORT | 2004-04-28 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
