| Entity Name: | SOUTHWEST BROWARD CORPORATION |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 08 Sep 1987 (37 years ago) |
| Document Number: | J91078 |
| FEI/EIN Number | 650012379 |
| Address: | % IVAN C. FREDERICKSON, 2000 PGA BLVD., SUITE 2204, N. PALM BCH., FL, 33408 |
| Mail Address: | % IVAN C. FREDERICKSON, 2000 PGA BLVD., SUITE 2204, N. PALM BCH., FL, 33408 |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053580027 | 2008-02-25 | 2008-02-25 | 18503 PINES BLVD, SUITE 305, PEMBROKE PINES, FL, 330291404, US | 18503 PINES BLVD, SUITE 305, PEMBROKE PINES, FL, 330291404, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-392-1851 |
Authorized person
| Name | DR. ALVARO BETANCUR |
| Role | PRESIDENT |
| Phone | 9543921851 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 12267 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QE0002X - Emergency Care Clinic/Center |
| License Number | 12267 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| License Number | 12267 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QS0112X - Oral and Maxillofacial Surgery Clinic/Center |
| License Number | 12267 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FREDERICKSON, IVAN C. | Agent | 2000 PGA BLVD, N. PALM BCH., FL, 33408 |
| Name | Role | Address |
|---|---|---|
| FREDERICKSON, IVAN C. | Director | 2000 PGA BLVD., SUITE 2204, N. PALM BCH., FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1996-08-23 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
