| Entity Name: | PULMONARY MEDICINE ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 11 May 1998 (27 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 09 Oct 2006 (18 years ago) |
| Document Number: | P98000043088 |
| FEI/EIN Number | 59-3508768 |
| Address: | 10101 West Colonial Drive, SUITE 102, Ocoee, FL 34761 |
| Mail Address: | 10101 West Colonial Drive, suite 102, ocoee, FL 34761 |
| ZIP code: | 34761 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023256062 | 2009-01-29 | 2021-02-09 | 10101 W COLONIAL DR STE 102, OCOEE, FL, 347614213, US | 10101 W COLONIAL DR STE 102, OCOEE, FL, 347614213, US | |||||||||||||||||||||
|
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| Phone | +1 407-895-9060 |
| Fax | 4078959010 |
Authorized person
| Name | JORGE L. HERNANDEZ |
| Role | OWNER/PRACTICING MD/CEO |
| Phone | 4078959060 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 375560600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SKAMBIS, CHRISTOPHER C | Agent | 720 RUGBY STREET SUITE 120, ORLANDO, FL 32804 |
| Name | Role | Address |
|---|---|---|
| Hernandez, Jorge L | Director | 10101 West Colonial Drive, Ste 102 Ocoee, FL 34761 |
| Name | Role | Address |
|---|---|---|
| Hernandez, Jorge L | President | 10101 West Colonial Drive, Ste 102 Ocoee, FL 34761 |
| Name | Role | Address |
|---|---|---|
| Hernandez, Jorge L | Secretary | 10101 West Colonial Drive, Ste 102 Ocoee, FL 34761 |
| Name | Role | Address |
|---|---|---|
| Hernandez, Jorge L | Treasurer | 10101 West Colonial Drive, Ste 102 Ocoee, FL 34761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-05-26 | 10101 West Colonial Drive, SUITE 102, Ocoee, FL 34761 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-14 | 10101 West Colonial Drive, SUITE 102, Ocoee, FL 34761 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-07-03 | 720 RUGBY STREET SUITE 120, ORLANDO, FL 32804 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-07-03 | SKAMBIS, CHRISTOPHER C | No data |
| CANCEL ADM DISS/REV | 2006-10-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| NAME CHANGE AMENDMENT | 2004-06-28 | PULMONARY MEDICINE ASSOCIATES, P.A. | No data |
| REINSTATEMENT | 2004-06-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2002-10-04 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-16 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-23 |
| ANNUAL REPORT | 2015-01-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
