| Entity Name: | BARRY M. WERNER M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Nov 1980 (44 years ago) |
| Document Number: | F04740 |
| FEI/EIN Number | 592041360 |
| Address: | 9863 golden dunes lane, boynton beach, FL, 33473, US |
| Mail Address: | 9863 golden dunes lane, boynton beach, FL, 33473, US |
| ZIP code: | 33473 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417984709 | 2006-06-26 | 2021-04-07 | 7421 N UNIVERSITY DR, SUITE 305, TAMARAC, FL, 333212977, US | 7421 N UNIVERSITY DR, SUITE 305, TAMARAC, FL, 333212977, US | |||||||||||||||||||||
|
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| Phone | +1 954-722-2000 |
| Fax | 9547222466 |
Authorized person
| Name | DR. BARRY MICHAEL WERNER |
| Role | PRESIDENT |
| Phone | 9547222000 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 057544500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WERNER, BARRY M | Agent | 9863 golden dunes lane, boynton beach, FL, 33473 |
| Name | Role | Address |
|---|---|---|
| WERNER, BARRY M | Director | 9863 golden dunes lane, boynton beach, FL, 33473 |
| Name | Role | Address |
|---|---|---|
| WERNER, BARRY M | President | 9863 golden dunes lane, boynton beach, FL, 33473 |
| Name | Role | Address |
|---|---|---|
| WERNER, BARRY M | Secretary | 9863 golden dunes lane, boynton beach, FL, 33473 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-03-14 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
