| Entity Name: | THE MEDICARE SHOPPE INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Mar 1998 (27 years ago) |
| Date of dissolution: | 10 Oct 2005 (19 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 10 Oct 2005 (19 years ago) |
| Document Number: | P98000020103 |
| FEI/EIN Number | 650817339 |
| Address: | 3013 EAST 4TH AVENUE, HIALEAH, FL, 33013 |
| Mail Address: | 3013 EAST 4TH AVENUE, HIALEAH, FL, 33013 |
| ZIP code: | 33013 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326045345 | 2005-07-05 | 2020-08-22 | 3013 E 4TH AVE, HIALEAH, FL, 330133210, US | 3013 E 4TH AVE, HIALEAH, FL, 330133210, US | |||||||||||||||||||||||||||
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| Phone | +1 305-693-3544 |
| Fax | 3056933519 |
Authorized person
| Name | MR. LUIS ANDRES FERNANDEZ |
| Role | PRESIDENT / PROGRAM DIRECTOR |
| Phone | 3056933544 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1222810001 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH16014 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DIEGUEZ ANTHONY P | Agent | 7950 NW 155TH STREET, MIAMI LAKES, FL, 33016 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ LUIS A | President | 3013 EAST 4TH AVENUE, HIALEAH, FL, 33013 |
| FERNANDEZ EDDA I | President | 3013 EAST FOURTH AVE., HIALEAH, FL, 33013 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ EDDA I | Vice President | 3013 EAST FOURTH AVE., HIALEAH, FL, 33013 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ EDDA I | Secretary | 3013 EAST FOURTH AVE., HIALEAH, FL, 33013 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ EDDA I | Treasurer | 3013 EAST FOURTH AVE., HIALEAH, FL, 33013 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2005-10-10 | No data | No data |
| NAME CHANGE AMENDMENT | 2005-07-15 | THE MEDICARE SHOPPE INCORPORATED | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-01-14 | 7950 NW 155TH STREET, 207, MIAMI LAKES, FL 33016 | No data |
| REGISTERED AGENT NAME CHANGED | 2001-02-05 | DIEGUEZ, ANTHONY P.A. | No data |
| AMENDMENT | 1999-10-29 | No data | No data |
| AMENDMENT | 1998-03-25 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J06900010533 | LAPSED | 06-004319 | 17TH JUD CIR BROWARD CIR CRT | 2006-06-29 | 2011-07-14 | $143453.37 | AMERISOURCEBERGEN DRUG CORPORATION, C/O ROGER MCMULLEN, 2100 DIRECTORS ROW, ORLANDO, FL 32809 |
| J02000156905 | LAPSED | 01-7323 CA 02 | MIAMI-DADE COUNTY | 2002-03-19 | 2007-04-22 | $375,585.00 | BINDLEY WESTERN INDUSTRIES INC D/B/A BINDLEY WESTERN DR, 8909 PURDUE ROAD, INDIANAPOLIS IN 46268 |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2005-10-10 |
| Name Change | 2005-07-15 |
| ANNUAL REPORT | 2005-07-14 |
| ANNUAL REPORT | 2004-01-14 |
| ANNUAL REPORT | 2003-03-13 |
| ANNUAL REPORT | 2002-03-29 |
| ANNUAL REPORT | 2001-02-05 |
| ANNUAL REPORT | 2000-07-28 |
| ANNUAL REPORT | 2000-05-17 |
| Amendment | 1999-10-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
