| Entity Name: | ALAN K. NOVICK, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jan 2003 (22 years ago) |
| Date of dissolution: | 25 Feb 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 25 Feb 2015 (10 years ago) |
| Document Number: | P03000011717 |
| FEI/EIN Number | 550812906 |
| Address: | 16481 Ontario Place, Davie, FL, 33331, US |
| Mail Address: | 15751 SHERIDAN STREET, #215, FORT LAUDERDALE, FL, 33331 |
| ZIP code: | 33331 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841305893 | 2006-08-20 | 2008-07-23 | 1150 N 35TH AVE, SUITE 390, HOLLYWOOD, FL, 330215424, US | 1150 N 35TH AVE, SUITE 390, HOLLYWOOD, FL, 330215424, US | |||||||||||||||||||||||||||||||
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| Phone | +1 954-981-3341 |
| Fax | 9549813476 |
Authorized person
| Name | DR. ALAN KEITH NOVICK |
| Role | PRESIDENT |
| Phone | 9549813341 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | ME0059686 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 271838300 |
| State | FL |
| Issuer | RAILIROAD MEDICARE |
| Number | P00009198 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NOVICK ALAN K | Agent | 16481 ONTARIO PLACE, DAVIE, FL, 33331 |
| Name | Role | Address |
|---|---|---|
| NOVICK ALAN K | President | 16481 ONTARIO PLACE, DAVIE, FL, 33331 |
| Name | Role | Address |
|---|---|---|
| NOVICK ALAN K | Director | 16481 ONTARIO PLACE, DAVIE, FL, 33331 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09079900112 | REHABILITATION PHYSICIANS OF SOUTH FLORIDA | EXPIRED | 2009-03-20 | 2014-12-31 | No data | 15751 SHERIDAN STREET, #215, FORT LAUDERDALE, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-02-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-03 | 16481 Ontario Place, Davie, FL 33331 | No data |
| CHANGE OF MAILING ADDRESS | 2005-07-07 | 16481 Ontario Place, Davie, FL 33331 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-02-25 |
| ANNUAL REPORT | 2014-02-03 |
| ANNUAL REPORT | 2013-03-28 |
| ANNUAL REPORT | 2012-04-10 |
| ANNUAL REPORT | 2011-03-25 |
| ANNUAL REPORT | 2010-01-08 |
| ANNUAL REPORT | 2009-03-10 |
| ANNUAL REPORT | 2008-04-22 |
| ANNUAL REPORT | 2007-02-15 |
| ANNUAL REPORT | 2006-04-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
