| Entity Name: | RAMON A. GUEVARA, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 May 1995 (30 years ago) |
| Document Number: | P95000035745 |
| FEI/EIN Number | 650548832 |
| Address: | 45 N.W. 8TH STREET, SUITE 110, HOMESTEAD, FL, 33030, US |
| Mail Address: | 45 N.W. 8th Street, Homestead, FL, 33030, US |
| ZIP code: | 33030 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598411555 | 2022-02-28 | 2024-10-07 | 45 NW 8TH ST STE 110, HOMESTEAD, FL, 330304452, US | 45 NW 8TH ST STE 106, HOMESTEAD, FL, 330304452, US | |||||||||||||||||||||
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| Phone | +1 305-248-1900 |
| Fax | 3052481902 |
Authorized person
| Name | RAMON A GUEVARA |
| Role | PRESIDENT |
| Phone | 3057917773 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002958900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GUEVARA RAMON A | Agent | 45 N.W. 8th Street, Homestead, FL, 33030 |
| Name | Role | Address |
|---|---|---|
| GUEVARA RAMON A | President | 45 N.W. 8th Street, Homestead, FL, 33030 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000094125 | VALOR MEDICAL CENTERS | ACTIVE | 2021-07-19 | 2026-12-31 | No data | 45 N.W. 8TH STREET, SUITE 110, HOMESTEAD, FL, 33030 |
| G20000029759 | WEST KENDALL PEDIATRICS | ACTIVE | 2020-03-09 | 2025-12-31 | No data | 16650 SW 88 ST, SUITE 105, MIAMI, FL, 33196 |
| G19000039487 | HOMESTEAD PEDIATRICS | ACTIVE | 2019-03-27 | 2029-12-31 | No data | 45 N.W. 8TH STREET, 110, HOMESTEAD, FL, 33030 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2012-11-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
