| Entity Name: | BROWARD INTEGRATIVE MEDICAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 23 Oct 2017 (7 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L17000219778 |
| FEI/EIN Number | 84-4735944 |
| Address: | 1749 NE 26th Street, Suite E, Wilton Manors, FL 33305 |
| Mail Address: | 1749 NE 26TH ST STE E, WILTON MANORS, FL 33305 |
| ZIP code: | 33305 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184228975 | 2020-11-23 | 2020-11-23 | 1749 NE 26TH ST STE E, WILTON MANORS, FL, 333051428, US | 1749 NE 26TH ST STE E, WILTON MANORS, FL, 333051428, US | |||||||||||||||||||||||||
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| Phone | +1 754-218-7163 |
Authorized person
| Name | MR. RAINFORD POYSER |
| Role | OWNER |
| Phone | 7542187163 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QI0500X - Infusion Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| POYSER, RAINFORD G | Agent | 749 NW 89TH AVENUE, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| POYSER, RAINFORD G | Manager | 749 NW 89TH AVENUE, PLANTATION, FL 33324 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000030265 | BROWARD INTEGRATIVE MEDICAL | ACTIVE | 2020-03-10 | 2025-12-31 | No data | 749 NW 89TH AVE, PLANTATION, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-06 | 1749 NE 26th Street, Suite E, Wilton Manors, FL 33305 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-15 | 1749 NE 26th Street, Suite E, Wilton Manors, FL 33305 | No data |
| REINSTATEMENT | 2019-11-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-11-24 | POYSER, RAINFORD G | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-03-06 |
| ANNUAL REPORT | 2020-03-15 |
| REINSTATEMENT | 2019-11-24 |
| Florida Limited Liability | 2017-10-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2526259006 | 2021-05-17 | 0455 | PPP | 1749 NE 26th St, Wilton Manors, FL, 33305-1428 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Feb 2025
Sources: Florida Department of State
