| Entity Name: | HOLLYWOOD PAVILION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 Feb 2001 (24 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L01000002341 |
| FEI/EIN Number | 651123348 |
| Address: | 2421 NE 32 Court, Lighthouse Point, FL, 33064, US |
| Mail Address: | 2421 NE 32 Court, Lighthouse Point, FL, 33064, US |
| ZIP code: | 33064 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326027723 | 2006-01-13 | 2020-08-22 | 1201 N 37TH AVE, HOLLYWOOD, FL, 330215414, US | 1201 N 37TH AVE, HOLLYWOOD, FL, 330215414, US | |||||||||||||||||||||||||
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| Phone | +1 954-962-1355 |
| Fax | 9549815520 |
Authorized person
| Name | KAREN KALLEN-ZURY |
| Role | CEO |
| Phone | 9549621355 |
Taxonomy
| Taxonomy Code | 283Q00000X - Psychiatric Hospital |
| License Number | 4361 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS PROVIDER NUMBE |
| Number | E80 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Zury Tamir | Agent | 2421 N.E. 32nd Court, Lighthouse Point, FL, 330648081 |
| Name | Role |
|---|---|
| HIGH RIDGE MANAGEMENT CORP. | Managing Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-19 | 2421 N.E. 32nd Court, Lighthouse Point, FL 33064-8081 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-06-19 | Zury, Tamir | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-05-09 | 2421 NE 32 Court, Lighthouse Point, FL 33064 | No data |
| CHANGE OF MAILING ADDRESS | 2016-05-09 | 2421 NE 32 Court, Lighthouse Point, FL 33064 | No data |
| LC AMENDMENT | 2014-08-28 | No data | No data |
| LC AMENDMENT | 2011-01-24 | No data | No data |
| LC AMENDMENT | 2009-04-02 | No data | No data |
| LC AMENDMENT | 2007-01-08 | No data | No data |
| AMENDMENT | 2005-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-19 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-05-09 |
| ANNUAL REPORT | 2015-04-28 |
| LC Amendment | 2014-08-28 |
| ANNUAL REPORT | 2014-04-22 |
| USDOT Number | Carrier Operation | MCS-150 Form Date | MCS-150 Mileage | MCS-150 Year | Power Units | Drivers | Operation Classification | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1289665 | Intrastate Non-Hazmat | 2004-09-27 | 60000 | 2003 | - | 5 | Priv. Pass. (Business) | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Total Number of Inspections for the measurement period (24 months) | 0 |
| Driver Fitness BASIC Serious Violation Indicator | No |
| Vehicle Maintenance BASIC Acute/Critical Indicator | No |
| Unsafe Driving BASIC Acute/Critical Indicator | No |
| Driver Fitness BASIC Roadside Performance measure value | 0 |
| Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value | 0 |
| Total Number of Driver Inspections for the measurment period | 0 |
| Vehicle Maintenance BASIC Roadside Performance measure value | 0 |
| Total Number of Vehicle Inspections for the measurement period | 0 |
| Controlled Substances and Alcohol BASIC Roadside Performance measure value | 0 |
| Unsafe Driving BASIC Roadside Performance Measure Value | 0 |
| Number of inspections with at least one Driver Fitness BASIC violation | 0 |
| Number of inspections with at least one Hours-of-Service BASIC violation | 0 |
| Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation | 0 |
| Number of inspections with at least one Vehicle Maintenance BASIC violation | 0 |
| Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation | 0 |
| Number of inspections with at least one Controlled Substances and Alcohol BASIC violation | 0 |
| Number of inspections with at least one Unsafe Driving BASIC violation | 0 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
