| Entity Name: | DANIEL M. JACOBS, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 17 Jan 2003 (22 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P03000006989 |
| FEI/EIN Number | 55-0820491 |
| Mail Address: | 319 S RIVERSIDE DRIVE, POMPANO BEACH, FL 33062 |
| Address: | 319 SOUTH RIVERSIDE DRIVE, POMPANO BEACH, FL 33062 |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598201790 | 2017-01-11 | 2017-01-11 | 2331 N STATE ROAD 7, LAUDERDALE LAKES, FL, 333133748, US | 319 S RIVERSIDE DR, POMPANO BEACH, FL, 330625526, US | |||||||||||||||||||||
|
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| Phone | +1 954-895-2862 |
Authorized person
| Name | DANIEL JACOBS |
| Role | OWNER |
| Phone | 9548952862 |
Taxonomy
| Taxonomy Code | 207ZP0102X - Anatomic Pathology & Clinical Pathology Physician |
| License Number | ME83309 |
| State | NY |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| FILINGS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| JACOBS, DANIEL M, Dr. | Chief Executive Officer | 319 S RIVERSIDE DRIVE, POMPANO BEACH, FL 33062 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-03 | 319 SOUTH RIVERSIDE DRIVE, POMPANO BEACH, FL 33062 | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-03 | 319 SOUTH RIVERSIDE DRIVE, POMPANO BEACH, FL 33062 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-19 | 3732 N.W. 16TH STREET, FT. LAUDERDALE, FL 33311 | No data |
| CANCEL ADM DISS/REV | 2004-12-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-11 |
| ANNUAL REPORT | 2017-01-03 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-01-15 |
| ANNUAL REPORT | 2014-09-11 |
| ANNUAL REPORT | 2013-07-11 |
| ANNUAL REPORT | 2012-01-10 |
| ANNUAL REPORT | 2011-01-24 |
| ANNUAL REPORT | 2010-02-17 |
| ANNUAL REPORT | 2009-01-19 |
Date of last update: 06 Jan 2025
Sources: Florida Department of State
