| Entity Name: | D. DE LA VEGA MD P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
D. DE LA VEGA MD P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 09 Aug 1996 (29 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Apr 2012 (13 years ago) |
| Document Number: | P96000066346 |
| FEI/EIN Number |
650681728
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 11093 NW 138 STREET, SUITE 112, HIALEAH GARDENS, FL, 33018, US |
| Mail Address: | 3200 SW 128TH AVE, MIAMI, FL, 33175 |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063464527 | 2006-05-16 | 2020-02-19 | 11093 NW 138TH ST UNIT 112, HIALEAH GARDENS, FL, 330181190, US | 11093 NW 138TH ST UNIT 112, HIALEAH GARDENS, FL, 330181190, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-552-0303 |
| Fax | 3055540709 |
Authorized person
| Name | DR. DAGOBERTO DE LA VEGA |
| Role | PRESIDENT |
| Phone | 3052989100 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME67856 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 377494501 |
| State | FL |
| Issuer | BCBS PROVIDER# |
| Number | 26980 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DE LA VEGA DAGOBERTO | Director | 3200 SW 128TH AVE, MIAMI, FL, 33175 |
| DE LA VEGA DAGOBERTO | President | 3200 SW 128TH AVE, MIAMI, FL, 33175 |
| DE LA VEGA DAGOBERTO | Secretary | 3200 SW 128TH AVE, MIAMI, FL, 33175 |
| DE LA VEGA DAGOBERTO | Treasurer | 3200 SW 128TH AVE, MIAMI, FL, 33175 |
| DE LA VEGA DAGOBERTO | Agent | 3200 S W 128TH AVE, MIAMI, FL, 33175 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000015434 | ALL AMERICAN COMPLIANCE GROUP | EXPIRED | 2019-01-29 | 2024-12-31 | - | 11093 NW 138 STREET, SUITE 112, HIALEAH GARDENS, FL, 33018 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-28 | 11093 NW 138 STREET, SUITE 112, HIALEAH GARDENS, FL 33018 | - |
| REINSTATEMENT | 2012-04-23 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | - | - |
| REINSTATEMENT | 2010-07-14 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2005-05-02 | 3200 S W 128TH AVE, MIAMI, FL 33175 | - |
| REINSTATEMENT | 2005-05-02 | - | - |
| CHANGE OF MAILING ADDRESS | 2005-05-02 | 11093 NW 138 STREET, SUITE 112, HIALEAH GARDENS, FL 33018 | - |
| REGISTERED AGENT NAME CHANGED | 2005-05-02 | DE LA VEGA, DAGOBERTO | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J21000023998 | TERMINATED | 1000000872677 | DADE | 2021-01-13 | 2031-01-20 | $ 1,288.41 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J19000682714 | TERMINATED | 1000000843659 | DADE | 2019-10-11 | 2029-10-16 | $ 712.54 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J19000681526 | TERMINATED | 1000000843256 | MIAMI-DADE | 2019-10-10 | 2029-10-16 | $ 402.03 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J17000615270 | TERMINATED | 1000000760864 | DADE | 2017-10-25 | 2027-11-02 | $ 1,044.88 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-05-08 |
| ANNUAL REPORT | 2019-03-03 |
| ANNUAL REPORT | 2018-03-17 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-03-27 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
