| Entity Name: | BERRY ORTHOPEDIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Mar 1995 (30 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P95000017287 |
| FEI/EIN Number | 650571924 |
| Address: | 1875 NE 163RD STREET, NORTH MIAMI BEACH, FL, 33162 |
| Mail Address: | P.O. BOX 540596, OPALOCKA, FL, 33054 |
| ZIP code: | 33162 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831379817 | 2007-11-07 | 2018-08-29 | PO BOX 540596, OPA LOCKA, FL, 330540596, US | 1875 NE 163RD ST, NORTH MIAMI BEACH, FL, 33162, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 305-651-3040 |
| Fax | 3056513237 |
Authorized person
| Name | MR. RAYMOND BERRY |
| Role | PRESIDENT/ OWNER |
| Phone | 3056513040 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | POR 107 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | POR 107 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019871100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BERRY RAYMOND | Agent | 1875 NE 163RD STREET, NORTH MIAMI BEACH, FL, 33162 |
| Name | Role | Address |
|---|---|---|
| BERRY RAYMOND | President | PO BOX 540596, OPA LOCKA, FL, 33054 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-23 | 1875 NE 163RD STREET, NORTH MIAMI BEACH, FL 33162 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-23 | 1875 NE 163RD STREET, NORTH MIAMI BEACH, FL 33162 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-12 | 1875 NE 163RD STREET, NORTH MIAMI BEACH, FL 33162 | No data |
| REGISTERED AGENT NAME CHANGED | 1999-03-01 | BERRY, RAYMOND | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-19 |
| ANNUAL REPORT | 2019-03-14 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-01 |
| ANNUAL REPORT | 2014-01-30 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-01-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
