| Entity Name: | MICHAEL S. FALKOWITZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 25 Mar 1983 (42 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | G30437 |
| FEI/EIN Number | 59-2265528 |
| Address: | 951 NW 13th St., SUITE 2A, BOCA RATON, FL 33486 |
| Mail Address: | 951 N.W. 13TH STREET, SUITE 2A, BOCA RATON, FL 33486 |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861425134 | 2006-07-09 | 2022-07-21 | 951 NW 13TH ST, SUITE 2A, BOCA RATON, FL, 334862359, US | 951 NW 13TH ST, SUITE 2A, BOCA RATON, FL, 334862359, US | |||||||||||||||||||||||||
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| Phone | +1 561-391-5771 |
| Fax | 5613918619 |
Authorized person
| Name | DR. MICHAEL S. FALKOWITZ |
| Role | PRESIDENT |
| Phone | 5613915771 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 036194 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/ BLUE SHIELD |
| Number | 50958 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gutter Chaves | Agent | Boca Corporate Center, 2101 Corporate Blvd, Suite 107, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| FALKOWITZ, MICHAEL | President | 951 N.W. 13TH STREET, SUITE 2A, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| FALKOWITZ, MICHAEL | Vice President | 951 N.W. 13TH STREET, SUITE 2A, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| FALKOWITZ, MICHAEL | Secretary | 951 N.W. 13TH STREET, SUITE 2A, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| FALKOWITZ, MICHAEL | Treasurer | 951 N.W. 13TH STREET, SUITE 2A, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| FALKOWITZ, MICHAEL | Director | 951 N.W. 13TH STREET, SUITE 2A, BOCA RATON, FL 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-06-17 | 951 NW 13th St., SUITE 2A, BOCA RATON, FL 33486 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-03-11 | Gutter Chaves | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-03-11 | Boca Corporate Center, 2101 Corporate Blvd, Suite 107, BOCA RATON, FL 33431 | No data |
| REINSTATEMENT | 1999-02-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 1991-05-30 | 951 NW 13th St., SUITE 2A, BOCA RATON, FL 33486 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-06-17 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-04-15 |
| ANNUAL REPORT | 2016-04-23 |
| ANNUAL REPORT | 2015-04-19 |
| ANNUAL REPORT | 2014-04-20 |
| ANNUAL REPORT | 2013-03-11 |
| ANNUAL REPORT | 2012-02-14 |
| Reg. Agent Change | 2011-06-27 |
| ANNUAL REPORT | 2011-04-23 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
