| Entity Name: | CURTIS JOHN CORGAN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 Feb 2010 (15 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L10000012923 |
| FEI/EIN Number | 27-1838715 |
| Mail Address: | 12300 SW 69TH PLACE, PINECREST, FL, 33156 |
| Address: | 12300 SW 69TH PLACE, PINECREST, FL, 33156, US |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538491204 | 2010-02-05 | 2010-02-05 | 12300 SW 69TH PL, PINECREST, FL, 331565436, US | 12300 SW 69TH PL, PINECREST, FL, 331565436, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 954-258-3899 |
Authorized person
| Name | DR. CURTIS JOHN CORGAN |
| Role | PRESIDENT |
| Phone | 9542583899 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME 93407 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 275013900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORGAN CURTIS J | Agent | 12300 SW 69TH PLACE, PINECREST, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| CORGAN CURTIS J | Managing Member | 12300 SW 69TH PLACE, PINECREST, FL, 33156 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-20 | 12300 SW 69TH PLACE, PINECREST, FL 33156 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-20 | CORGAN, CURTIS J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-20 | 12300 SW 69TH PLACE, PINECREST, FL 33156 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-09-18 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-02-01 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-02-26 |
| ANNUAL REPORT | 2015-04-20 |
| ANNUAL REPORT | 2014-01-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
