| Entity Name: | HANOVER MEDICAL SERVICES OF DADE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 20 Jul 1992 (33 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 08 Jan 2016 (9 years ago) |
| Document Number: | V51801 |
| FEI/EIN Number | 65-0376352 |
| Address: | 13645 SW 82ND AVE, Miami, FL 33158 |
| Mail Address: | 13645 SW 82ND AVE, Miami, FL 33158 |
| ZIP code: | 33158 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700399664 | 2017-11-14 | 2017-11-15 | 8180 DORAL BLVD STE 416, DORAL, FL, 331666686, US | 8180 DORAL BLVD STE 416, DORAL, FL, 331666686, US | |||||||||||||||||||
|
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| Phone | +1 305-592-5225 |
Authorized person
| Name | ED LARGAESAPADA |
| Role | CEO |
| Phone | 3055925225 |
Taxonomy
| Taxonomy Code | 261QC1800X - Corporate Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 990561800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LARGAESPADA, BLANCA | Agent | 13645 SW 82ND AVE, Miami, FL 33158 |
| Name | Role | Address |
|---|---|---|
| LARGAESPADA, ED | President | 9737 NW 41st Street, SUITE 742 DORAL, FL 33166 |
| Name | Role | Address |
|---|---|---|
| LARGAESPADA, ED | Treasurer | 9737 NW 41st Street, SUITE 742 DORAL, FL 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-24 | 13645 SW 82ND AVE, Miami, FL 33158 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-24 | 13645 SW 82ND AVE, Miami, FL 33158 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-24 | 13645 SW 82ND AVE, Miami, FL 33158 | No data |
| AMENDMENT | 2016-01-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-01-08 | LARGAESPADA, BLANCA | No data |
| REINSTATEMENT | 1996-10-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1996-08-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-03-27 |
| ANNUAL REPORT | 2021-03-24 |
| ANNUAL REPORT | 2020-05-24 |
| ANNUAL REPORT | 2019-04-06 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-01-20 |
| ANNUAL REPORT | 2016-03-06 |
| Amendment | 2016-01-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
