| Entity Name: | MARTINEZ DRUG STORE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 15 Jul 1994 (31 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 26 May 2015 (10 years ago) |
| Document Number: | P94000052494 |
| FEI/EIN Number | 65-0510837 |
| Address: | 874 E 41ST STREET, HIALEAH, FL 33013 |
| Mail Address: | 874 E 41ST STREET, HIALEAH, FL 33013 |
| ZIP code: | 33013 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659465342 | 2006-10-03 | 2020-08-22 | 874 E 41 STREET, HIALEAH, FL, 33013, US | 874 E 41 STREET, HIALEAH, FL, 33013, US | |||||||||||||||||||||||||
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| Phone | +1 305-693-0441 |
| Fax | 3056930680 |
Authorized person
| Name | ALINA TABIBI |
| Role | PRESIDENT |
| Phone | 3056930441 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PS16294 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 10286201 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NEGRIN, RUBEN | Agent | 874 E. 41 ST., HIALEAH, FL 33013 |
| Name | Role | Address |
|---|---|---|
| NEGRIN, RUBEN | President | 874 E 41ST STREET, HIALEAH, FL 33013 |
| Name | Role | Address |
|---|---|---|
| DOMINGUEZ, ADA | Vice President | 874 E 41ST STREET, HIALEAH, FL 33013 |
| Name | Role | Address |
|---|---|---|
| NEGRIN, RONALD | Treasurer | 874 E 41ST STREET, HIALEAH, FL 33013 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2015-05-26 | No data | No data |
| AMENDMENT | 2007-08-29 | No data | No data |
| AMENDMENT | 2007-03-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-03-05 | NEGRIN, RUBEN | No data |
| AMENDMENT | 2007-03-05 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2001-05-11 | 874 E. 41 ST., HIALEAH, FL 33013 | No data |
| CHANGE OF MAILING ADDRESS | 2000-08-02 | 874 E 41ST STREET, HIALEAH, FL 33013 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2000-08-02 | 874 E 41ST STREET, HIALEAH, FL 33013 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-03-22 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-02-23 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-08 |
| Amendment | 2015-05-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
