Entity Name: | PALM MEDICAL INSTITUTE INC. |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Inactive |
Date Filed: | 26 Jun 1996 (29 years ago) |
Document Number: | P96000054338 |
FEI/EIN Number | 650675174 |
Address: | 55 W. 29 ST., HIALEAH, FL, 33012 |
Mail Address: | 55 W. 29 ST., HIALEAH, FL, 33012 |
ZIP code: | 33012 |
County: | Miami-Dade |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1831130277 | 2006-06-09 | 2020-08-22 | 55 W 29 ST, HIALEAH, FL, 33012, US | 55 W 29 ST, HIALEAH, FL, 33012, US | |||||||||||||||
|
Phone | +1 305-883-8467 |
Fax | 3058832997 |
Authorized person
Name | BLANCA GONZALEZ |
Role | PRESIDENT |
Phone | 3058838467 |
Taxonomy
Taxonomy Code | 208D00000X - General Practice Physician |
Is Primary | Yes |
Name | Role | Address |
---|---|---|
GONZALEZ BLANCA N | Agent | 55 W 29 ST., HIALEAH, FL, 33012 |
Name | Role | Address |
---|---|---|
GONZALEZ BLANCA N | President | 55 W 29 ST., HIALEAH, FL, 33012 |
Name | Role | Address |
---|---|---|
NIEVES GONZALEZ BLANCA | Director | 561 SW 73RD AVE, MIAMI, FL, 33144 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
AMENDMENT | 1996-07-11 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State