| Entity Name: | MYLES K. KRIEGER, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 May 1983 (42 years ago) |
| Document Number: | G36986 |
| FEI/EIN Number | 592287969 |
| Address: | 10130 SWEET BAY STREET, PLANTATION, FL, 33324, US |
| Mail Address: | 10130 SWEET BAY STREET, PLANTATION, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104128438 | 2010-11-18 | 2010-11-18 | 4340 SHERIDAN ST, SUITE #202, HOLLYWOOD, FL, 330213567, US | 4340 SHERIDAN ST, SUITE #202, HOLLYWOOD, FL, 330213567, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 954-963-3222 |
Authorized person
| Name | ANA CAMPOS |
| Role | ACCOUNT MANAGER |
| Phone | 9549633222 |
Taxonomy
| Taxonomy Code | 207YX0905X - Otolaryngology/Facial Plastic Surgery Physician |
| License Number | ME26172 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE NUMBER |
| Number | ME26172 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KRIEGER MD, MYLES K | Agent | 10130 SWEET BAY STREET, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| KRIEGER, MYLES K | Director | 10130 SWEET BAY STREET, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| KRIEGER, MYLES K | President | 10130 SWEET BAY STREET, PLANTATION, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
