| Entity Name: | AIRPORT MEDICAL CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Aug 1984 (40 years ago) |
| Document Number: | H16545 |
| FEI/EIN Number | 592456779 |
| Address: | C/O IRWIN M. POTASH, 3588 N.W. 72ND AVENUE, MIAMI, FL, 33122 |
| Mail Address: | C/O IRWIN M. POTASH, 3588 N.W. 72ND AVENUE, MIAMI, FL, 33122 |
| ZIP code: | 33122 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528106473 | 2007-02-02 | 2020-08-22 | 3607 OLD CONEJO RD, THOUSAND OAKS, CA, 913202123, US | 3588 NW 72ND AVE, MIAMI, FL, 331221324, US | |||||||||||||||||||
|
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| Phone | +1 805-375-0800 |
| Phone | +1 305-592-5205 |
Authorized person
| Name | DR. IRWIN POTASH |
| Role | PHYSICIAN |
| Phone | 3055925205 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | BP5261639 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| POTASH, IRWIN M. | Agent | 3588 N.W. 72ND AVENUE, MIAMI, FL, 33122 |
| Name | Role | Address |
|---|---|---|
| POTASH, IRWIN M. | Director | 3588 N.W. 72ND AVENUE, MIAMI, FL |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
