| Entity Name: | CICERO ORTHO-MED CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 27 Jan 1997 (28 years ago) |
| Document Number: | P97000007551 |
| FEI/EIN Number | 65-0721807 |
| Mail Address: | 4567 NW 7th ST, MIAMI, FL 33126 |
| Address: | 4575 NW 7th ST, MIAMI, FL 33126 |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780772822 | 2006-10-11 | 2008-06-23 | 750 SW 49TH AVE, CORAL GABLES, FL, 331341307, US | 750 SW 49TH AVE, CORAL GABLES, FL, 331341307, US | |||||||||||||||||||||
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| Phone | +1 305-448-4002 |
| Fax | 3054481956 |
Authorized person
| Name | ANA CICERO |
| Role | PRESIDENT |
| Phone | 3054484002 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 251383800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CICERO, ANA | Agent | 4567 NW 7th ST, MIAMI, FL 33126 |
| Name | Role | Address |
|---|---|---|
| CICERO, ANA | President | 4567 NW 7th ST, MIAMI, FL 33126 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-27 | 4575 NW 7th ST, MIAMI, FL 33126 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-06 | 4575 NW 7th ST, MIAMI, FL 33126 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-09-06 | 4567 NW 7th ST, MIAMI, FL 33126 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-28 | CICERO, ANA | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-05-27 |
| ANNUAL REPORT | 2024-04-10 |
| AMENDED ANNUAL REPORT | 2023-09-06 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-01-22 |
| ANNUAL REPORT | 2017-02-15 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9049448300 | 2021-01-30 | 0455 | PPS | 750 SW 49th Ave, Coral Gables, FL, 33134-1307 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7555857204 | 2020-04-28 | 0455 | PPP | 750 SW 49TH AVE, CORAL GABLES, FL, 33134-1307 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
