| Entity Name: | SOUTH FLORIDA PULMONARY CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Aug 1990 (34 years ago) |
| Document Number: | S00571 |
| FEI/EIN Number | 650218850 |
| Address: | 5733 NW 151ST, MIAMI LAKES, FL, 33014, US |
| Mail Address: | 5733 NW 151ST, MIAMI LAKES, FL, 33014, US |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619930450 | 2006-04-11 | 2022-05-05 | 5733 NW 151ST ST, MIAMI LAKES, FL, 330142481, US | 5733 NW 151ST ST, MIAMI LAKES, FL, 330142481, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 305-826-4172 |
| Fax | 3058264178 |
Authorized person
| Name | MR. ERNESTO PADRON JR. |
| Role | PRESIDENT |
| Phone | 3058264172 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | HME # 701 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 028639700 |
| State | FL |
| Issuer | BC/BS DME PROVIDER |
| Number | R6307 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTH FLORIDA PULMONARY CARE, INC. DEFINED BENEFIT PLAN | 2014 | 650218850 | 2015-10-14 | SOUTH FLORIDA PULMONARY CARE, INC. | 2 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2015-10-14 |
| Name of individual signing | ERNESTO PADRON, JR. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 3058264172 |
| Plan sponsor’s address | 5733 NW 151 STREET, MIAMI LAKES, FL, 33014 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-11 |
| Name of individual signing | REBECCA TORRES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 3058264172 |
| Plan sponsor’s address | 5733 NW 151 STREET, MIAMI LAKES, FL, 33014 |
Signature of
| Role | Plan administrator |
| Date | 2013-10-14 |
| Name of individual signing | REBECCA TORRES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DUNKLEY LINDSAY | Agent | 14100 PALMETTO FRONTAGE RD, MIAMI LAKES, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| PADRON ERNESTO | Secretary | 5733 NW 151ST, MIAMI LAKES, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| PADRON ERNESTO | President | 5733 NW 151ST, MIAMI LAKES, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| PADRON ERNESTO | Vice President | 5733 NW 151ST, MIAMI LAKES, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| PADRON ERNESTO | Treasurer | 5733 NW 151ST, MIAMI LAKES, FL, 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2004-03-31 | No data | No data |
| AMENDMENT | 2000-12-08 | No data | No data |
| REINSTATEMENT | 1993-01-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1992-10-09 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
