| Entity Name: | QUALMED OF SOUTH DADE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Jun 1999 (26 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P99000051770 |
| FEI/EIN Number | 65-0925340 |
| Address: | 7805 SW 24 ST, SUITE 103, MIAMI, FL 33155 |
| Mail Address: | PO BOX 441206, MIAMI, FL 33144 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285611913 | 2005-12-23 | 2009-01-23 | 26085 S DIXIE HWY, NARANJA, FL, 330326613, US | 27535 S DIXIE HWY, NARANJA, FL, 330328225, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-246-2221 |
| Fax | 3052698825 |
Authorized person
| Name | MS. SANDRA MARIA PALACIO |
| Role | ADMINISTRATIVE ASSISTANT |
| Phone | 3053980807 |
Taxonomy
| Taxonomy Code | 173000000X - Legal Medicine |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 272061200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 063744100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 260520100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORDOVA, ANGEL D | Agent | 782 NW 42 AVENUE, SUITE 340, MIAMI, FL 33126 |
| Name | Role | Address |
|---|---|---|
| REGALADO, JOSE M | Chief Executive Officer | 7805 CORAL WAY SUITE 103, MIAMI, FL 33155-6539 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-16 | 7805 SW 24 ST, SUITE 103, MIAMI, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2009-07-01 | 7805 SW 24 ST, SUITE 103, MIAMI, FL 33155 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-07-01 | 782 NW 42 AVENUE, SUITE 340, MIAMI, FL 33126 | No data |
| AMENDMENT | 2007-12-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2005-09-22 | CORDOVA, ANGEL D | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-03-14 |
| ANNUAL REPORT | 2012-08-16 |
| ANNUAL REPORT | 2012-02-17 |
| ANNUAL REPORT | 2011-03-02 |
| ANNUAL REPORT | 2010-03-04 |
| ANNUAL REPORT | 2009-07-01 |
| ANNUAL REPORT | 2008-07-03 |
| Amendment | 2007-12-13 |
| ANNUAL REPORT | 2007-04-16 |
| ANNUAL REPORT | 2006-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
