| Entity Name: | FERNANDO PINO, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 31 Mar 1995 (30 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Sep 2016 (8 years ago) |
| Document Number: | P95000026643 |
| FEI/EIN Number | 65-0575651 |
| Address: | 11301 S. Dixie Hwy, #566207, MIAMI, FL 33256 |
| Mail Address: | PO Box 566207, MIAMI, FL 33256 |
| ZIP code: | 33256 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285923896 | 2011-04-04 | 2012-08-15 | 8600 SW 92ND STREET, SUITE # 104, MIAMI, FL, 331567377, US | 8600 SW 92ND STREET, SUITE # 104, MIAMI, FL, 331567377, US | |||||||||||||||||||||||||
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| Phone | +1 305-595-1949 |
| Fax | 3055956455 |
Authorized person
| Name | FERNANDO PINO |
| Role | MEDICAL DOCTOR |
| Phone | 3055951949 |
Taxonomy
| Taxonomy Code | 273R00000X - Psychiatric Hospital Unit |
| License Number | ME52016 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 371123400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PINO, FERNANDO M.D. | Agent | 11301 S. Dixie Hwy, #566207, MIAMI, FL 33256 |
| Name | Role | Address |
|---|---|---|
| PINO, FERNANDO | Director | PO Box 566207, MIAMI, FL 33256 |
| Name | Role | Address |
|---|---|---|
| PINO, FERNANDO | President | PO Box 566207, MIAMI, FL 33256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-22 | 11301 S. Dixie Hwy, #566207, MIAMI, FL 33256 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-22 | 11301 S. Dixie Hwy, #566207, MIAMI, FL 33256 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-22 | 11301 S. Dixie Hwy, #566207, MIAMI, FL 33256 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-09-29 | PINO, FERNANDO M.D. | No data |
| REINSTATEMENT | 2016-09-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CANCEL ADM DISS/REV | 2007-01-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1998-10-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-02-26 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-02-14 |
| REINSTATEMENT | 2016-09-29 |
| Reg. Agent Change | 2012-08-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
