| Entity Name: | CLARA LAGUERUELA, MD, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Sep 1999 (25 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 18 Dec 2022 (2 years ago) |
| Document Number: | P99000079509 |
| FEI/EIN Number | 650946158 |
| Address: | 9980 SW 40 STREET, MIAMI, FL, 33165 |
| Mail Address: | 11720 sw 67 ave, MIAMI, FL, 33156, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487015103 | 2016-03-08 | 2016-03-08 | 9980 SW 40TH ST, MIAMI, FL, 331653944, US | 9980 SW 40TH ST, MIAMI, FL, 331653944, US | |||||||||||||||||||||||||
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| Phone | +1 305-223-2255 |
| Fax | 3052232622 |
Authorized person
| Name | MRS. CLARA LAGUERUELA |
| Role | PRESIDENT |
| Phone | 3052232255 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME0059638 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS GROUP NUMBER |
| Number | RVOWW |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAGUERUELA CLARA M | Agent | 9980 SW 40 STREET, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| LAGUERUELA CLARA M | President | 9980 SW 40 STREET, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| LAGUERUELA CLARA M | Director | 9980 SW 40 STREET, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-25 | LAGUERUELA, CLARA MD | No data |
| REINSTATEMENT | 2016-10-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-10-25 | 9980 SW 40 STREET, MIAMI, FL 33165 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-03-11 | 9980 SW 40 STREET, MIAMI, FL 33165 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-03-11 | 9980 SW 40 STREET, MIAMI, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-28 |
| ANNUAL REPORT | 2023-05-16 |
| REINSTATEMENT | 2022-12-18 |
| ANNUAL REPORT | 2021-01-23 |
| ANNUAL REPORT | 2020-02-24 |
| ANNUAL REPORT | 2019-03-01 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-11 |
| REINSTATEMENT | 2016-10-25 |
| ANNUAL REPORT | 2015-01-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
