ULTRA MEDICAL CENTER, CORP
Marriage and Family Therapists at 23 Ave, Miami, FL

License number
Florida 136410067
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: JOSE N GONZALEZ M.D
Title: OWNER
Phone: (305) 644-7407
Address
Address
711 NW 23Rd Ave SUITE 304, Miami, FL 33125
National Provider ID: 1629028865
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ULTRA MEDICAL CENTER CORP

Miami, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Mar 10, 2006
Inactive since:
Sep 23, 2011
Addresses:
711 NW 23 Ave 304, Miami, FL 33125 (Physical)
711 NW 23 Ave, Miami, FL 33125
State ID:
P06000036436
Business type:
Florida Profit Corporation
Presidents:
Del Castillo, Cidic, 711 NW 23 Ave #304, Miami, FL 33125 (Physical),Jose N Gonzalez President, inactive, 711 NW 23 Ave #304, Miami, FL 33125 (Physical),Neyda Castillo President, Vice President, inactive, 711 NW 23 Ave #304, Miami, FL 33125 (Physical),...
Agent:
Del Castillo, Neyda,2898 SW 145 Ave, Miami, FL 33175 (Physical)
EIN:
743168054

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