| Entity Name: | HERSHMAN MEDICAL CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 29 Dec 1969 (55 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | 601813 |
| FEI/EIN Number | 59-1299464 |
| Address: | 13400 SW 120 STREET, SUITE 300 A, MIAMI, FL 33186 |
| Mail Address: | 13400 SW 120 STREET, SUITE 300 A, MIAMI, FL 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457361909 | 2006-08-08 | 2018-08-06 | 13400 SW 120TH ST STE 300A, MIAMI, FL, 331867441, US | 13400 SW 120TH ST STE 300A, MIAMI, FL, 331867441, US | |||||||||||||||||||||||||
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| Phone | +1 305-221-7235 |
| Fax | 3052201847 |
Authorized person
| Name | DR. LLOYD STEVEN HERSHMAN |
| Role | FAMILY PRACTICE |
| Phone | 3052217235 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031575300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERSHMAN, Kenneth D, Dr. | Agent | 13400 SW 120 STREET, SUITE 300 A, MIAMI, FL 33186 |
| Name | Role | Address |
|---|---|---|
| HERSHMAN, KENNETH DAVID , DR. | PRESIDENT | 13400 SW 120 STREET, SUITE 300 A MIAMI, FL 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-01-13 | HERSHMAN, Kenneth D, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-29 | 13400 SW 120 STREET, SUITE 300 A, MIAMI, FL 33186 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-29 | 13400 SW 120 STREET, SUITE 300 A, MIAMI, FL 33186 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-29 | 13400 SW 120 STREET, SUITE 300 A, MIAMI, FL 33186 | No data |
| NAME CHANGE AMENDMENT | 2008-01-28 | HERSHMAN MEDICAL CENTER, P.A. | No data |
| NAME CHANGE AMENDMENT | 1994-02-23 | HERSHMAN & HERSHMAN, P.A. | No data |
| REINSTATEMENT | 1986-09-25 | No data | No data |
| INVOL DISSOLUTION FOR ANNUAL REPORT | 1974-10-21 | No data | No data |
| NAME CHANGE AMENDMENT | 1970-11-06 | HERSHMAN AND SARNOW, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-28 |
| AMENDED ANNUAL REPORT | 2014-06-16 |
| ANNUAL REPORT | 2014-01-13 |
Date of last update: 06 Feb 2025
Sources: Florida Department of State
