| Entity Name: | FOOT & ANKLE SPECIALISTS OF MIAMI BEACH, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Aug 1983 (41 years ago) |
| Document Number: | G55631 |
| FEI/EIN Number | 592311527 |
| Address: | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140, US |
| Mail Address: | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140, US |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215127402 | 2007-07-25 | 2014-06-09 | 4308 ALTON RD, SUITE 710, MIAMI BEACH, FL, 331404558, US | 4308 ALTON RD, SUITE 710, MIAMI BEACH, FL, 331404558, US | |||||||||||||||||||||
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| Phone | +1 305-695-7777 |
| Fax | 3056957707 |
Authorized person
| Name | KEVIN BERKOWITZ |
| Role | PRESIDENT |
| Phone | 3056957777 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE GROUP |
| Number | 00289 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZUCKERMAN, LESLIE H. | Agent | 4000 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Name | Role | Address |
|---|---|---|
| KEVIN D. BERKOWITZ | President | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| NAME CHANGE AMENDMENT | 2000-12-27 | FOOT & ANKLE SPECIALISTS OF MIAMI BEACH, P.A. | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
