| Entity Name: | TUDELA PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Oct 1996 (28 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Jan 2024 (a year ago) |
| Document Number: | P96000088606 |
| FEI/EIN Number | 650704898 |
| Address: | 10961 SW 40 STREET, MIAMI, FL, 33165, US |
| Mail Address: | 10961 SW 40 STREET, MIAMI, FL, 33165, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629158829 | 2006-10-16 | 2024-01-25 | 10981 SW 40TH ST, MIAMI, FL, 331654412, US | 10981 SW 40TH ST, MIAMI, FL, 331654412, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 305-223-4841 |
| Fax | 3052231006 |
Authorized person
| Name | MARIA MAGADALENA GONZALEZ |
| Role | OWNER / PRESIDENT |
| Phone | 3052234841 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH14292 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NABP |
| Number | 1079385 |
| Issuer | MEDICAID |
| Number | 022874500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ MARIA | Agent | 10961 SW 40 STREET, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ MARIA | President | 10961 SW 40 ST., MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ MARIA | Vice President | 10961 SW 40 ST., MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ MARIA | Secretary | 10961 SW 40 ST., MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ MARIA | Treasurer | 10961 SW 40 ST., MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| DIAZ ALEX | Director | 10961 SW 40 STREET, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-17 | GONZALEZ, MARIA | No data |
| REINSTATEMENT | 2024-01-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| AMENDMENT | 2005-04-12 | No data | No data |
| AMENDMENT | 2001-12-07 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1997-01-24 | 10961 SW 40 STREET, MIAMI, FL 33165 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1997-01-24 | 10961 SW 40 STREET, MIAMI, FL 33165 | No data |
| CHANGE OF MAILING ADDRESS | 1997-01-24 | 10961 SW 40 STREET, MIAMI, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-28 |
| REINSTATEMENT | 2024-01-17 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-03-06 |
| ANNUAL REPORT | 2019-02-26 |
| ANNUAL REPORT | 2018-02-14 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-01 |
| ANNUAL REPORT | 2015-04-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
