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FTG ORTHO PLLC - Florida Company Profile

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Company Details

Entity Name: FTG ORTHO PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 06 Jun 2023 (2 years ago)
Document Number: L23000272901
FEI/EIN Number 93-1809922
Address: 1835 E Hallandale Beach Blvd, Hallandale, FL, 33009, US
Mail Address: 1835 E Hallandale Beach Blvd, Hallandale, FL, 33009, US
ZIP code: 33009
City: Hallandale
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
ROZENCWAIG RICHARD Manager 9900 E BROADVIEW DRIVE, BAY HARBOR, FL, 33154
LEWIS DOMINIC Manager 721 CONCHSHELL WAY, PLANTATION, FL, 33324

National Provider Identifier

NPI Number:
1942006275
Certification Date:
2025-02-19

Authorized Person:

Name:
DOMINIC J LEWIS
Role:
MGR
Phone:

Taxonomy:

Selected Taxonomy:
207XX0004X - Orthopaedic Foot and Ankle Surgery Physician
Is Primary:
No
Selected Taxonomy:
207XX0801X - Orthopaedic Trauma Physician
Is Primary:
No
Selected Taxonomy:
207XX0005X - Sports Medicine (Orthopaedic Surgery) Physician
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-23 1835 E Hallandale Beach Blvd, Box 443, Hallandale, FL 33009 -
CHANGE OF MAILING ADDRESS 2024-03-23 1835 E Hallandale Beach Blvd, Box 443, Hallandale, FL 33009 -

Documents

Name Date
ANNUAL REPORT 2024-03-23
Florida Limited Liability 2023-06-06

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Date of last update: 01 Jul 2025

Sources: Florida Department of State