EVANESCENCE INC
Radiology at Bird Rd, Miami, FL

License number
Florida ME 29633
Category
Radiology
Type
Vascular Surgery
Owner
Name: GUSTAVO G LEON M.D.
Title: MEDICAL DIRECTOR
Phone: (305) 598-8222
Address
Address 2
11760 Bird Rd SUITE 710, Miami, FL 33165
7100 Pines Blvd SUITE 23, Hollywood, FL 33024
National Provider ID: 1780628107
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about EVANESCENCE INC at bizstanding.com

EVANESCENCE, INC

Miami, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Mar 10, 2005
Inactive since:
Sep 28, 2012
Addresses:
6568 SW 39 Ct, Miami, FL 33155 (Physical)
15815 SW 50 Ter, Miami, FL 33185
6568 SW 39 Ter, Miami, FL 33155
State ID:
P05000040107
Business type:
Florida Profit Corporation
President, Director, Vice Presidents:
Eduardo Cantera Secretary, Treasurer, Vice President, Director, President, inactive, 6568 SW 39 Ct, Miami, FL 33155 (Physical),Gustavo G. Leon President, Director, Vice President, inactive
EIN:
651243052

Radiology licenses in Florida










Other Doctors licenses in Florida