| Entity Name: | JAN PAVLINEC, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 22 Nov 1983 (41 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | G71449 |
| FEI/EIN Number | 59-2345710 |
| Address: | 1161 S.E. 22ND AVE., POMPANO BEACH, FL 33062 |
| Mail Address: | 1161 S.E. 22ND AVE., POMPANO BEACH, FL 33062 |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124382940 | 2012-06-26 | 2012-06-26 | 1161 SE 22ND AVE, POMPANO BEACH, FL, 330627045, US | 1161 SE 22ND AVE, POMPANO BEACH, FL, 330627045, US | |||||||||||||||||||||||||
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| Phone | +1 954-785-7343 |
| Fax | 9547854636 |
Authorized person
| Name | DR. JAN PAVLINEC |
| Role | PRESIDENT |
| Phone | 9548012398 |
Taxonomy
| Taxonomy Code | 173000000X - Legal Medicine |
| License Number | MEO38469 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 062051300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PAVLINEC, LINDA LAVIS | Agent | 1161 SE 22ND AVE, POMPANO BEACH, FL 33062 |
| Name | Role | Address |
|---|---|---|
| PAVLINEC, LINDA LAVIS | Director | 1161 S.E. 22ND AVE., POMPANO BEACH, FL 33062 |
| PAVLINEC, JAN | Director | 1161 S.E. 22ND AVE., POMPANO BEACH, FL 33062 |
| Name | Role | Address |
|---|---|---|
| PAVLINEC, JAN | President | 1161 S.E. 22ND AVE., POMPANO BEACH, FL 33062 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-04-07 | 1161 SE 22ND AVE, POMPANO BEACH, FL 33062 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-03-02 | PAVLINEC, LINDA LAVIS | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-01-19 |
| ANNUAL REPORT | 2006-04-07 |
| ANNUAL REPORT | 2005-01-23 |
| ANNUAL REPORT | 2004-03-02 |
| ANNUAL REPORT | 2003-01-29 |
| ANNUAL REPORT | 2002-02-07 |
| ANNUAL REPORT | 2001-01-30 |
| ANNUAL REPORT | 2000-03-15 |
| ANNUAL REPORT | 1999-04-13 |
| ANNUAL REPORT | 1998-05-06 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
