| Entity Name: | OSCEOLA DENTAL INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Nov 1999 (25 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Jun 2015 (10 years ago) |
| Document Number: | P99000096618 |
| FEI/EIN Number | 593612320 |
| Address: | 3066 MICHIGAN AVE, KISSIMMEE, FL, 34744 |
| Mail Address: | 3066 MICHIGAN AVE, KISSIMMEE, FL, 34744 |
| ZIP code: | 34744 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356547418 | 2007-06-25 | 2015-09-02 | 3066 MICHIGAN AVE, KISSIMMEE, FL, 347441544, US | 3066 MICHIGAN AVE, KISSIMMEE, FL, 347441544, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-343-9800 |
| Fax | 4073439802 |
Authorized person
| Name | DR. ANAURA TIRADO VELAZQUEZ |
| Role | PRESIDENT |
| Phone | 4073439800 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN12467 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 074075600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VELAZQUEZ ANAURA T | Agent | 3066 MICHIGAN AVE, KISSIMMEE, FL, 34744 |
| Name | Role | Address |
|---|---|---|
| VELAZQUEZ ANAURA T | Director | 3066 MICHIGAN AVE, KISSIMMEE, FL, 34744 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2015-06-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-06-05 | VELAZQUEZ, ANAURA T | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2001-04-02 | 3066 MICHIGAN AVE, KISSIMMEE, FL 34744 | No data |
| CHANGE OF MAILING ADDRESS | 2001-04-02 | 3066 MICHIGAN AVE, KISSIMMEE, FL 34744 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2001-04-02 | 3066 MICHIGAN AVE, KISSIMMEE, FL 34744 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000308041 | TERMINATED | 1000000743453 | ORANGE | 2017-05-18 | 2027-06-01 | $ 384.13 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| J13000865890 | TERMINATED | 1000000495191 | ORANGE | 2013-04-18 | 2023-05-03 | $ 2,477.02 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MAITLAND SERVICE CENTER, 2301 MAITLAND CENTER PKWY STE 160, MAITLAND FL327514192 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-01-12 |
| REINSTATEMENT | 2015-06-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
