| Entity Name: | MINIMALLY INVASIVE SURGERY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Nov 2003 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 28 Oct 2024 (4 months ago) |
| Document Number: | P03000128851 |
| FEI/EIN Number | 200382179 |
| Address: | 2307 West Broward Blvd, Fort Lauderdale, FL, 33312, US |
| Mail Address: | P.O. Box 11705, Fort Lauderdale, FL, 33339, US |
| ZIP code: | 33312 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174656599 | 2007-03-14 | 2022-07-21 | 4101 N.W. 4TH STREET, SUITE 401, PLANTATION, FL, 333172813, US | 4101 N.W. 4TH STREET, SUITE 401, PLANTATION, FL, 333172813, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 954-797-4220 |
| Fax | 9547974221 |
Authorized person
| Name | DR. RONALD E MOORE JR. |
| Role | SURGEON |
| Phone | 9547974220 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274253500 |
| State | FL |
| Issuer | BCBS |
| Number | 71634 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOORE, JR. RONALD EDr. | Agent | 2307 West Broward Blvd, Fort Lauderdale, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| Moore Ronald EDr. | President | 2307 West Broward Blvd, Fort Lauderdale, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| Moore Ronald EDr. | Vice President | 2307 West Broward Blvd, Fort Lauderdale, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| Moore Ronald EDr. | Secretary | 2307 West Broward Blvd, Fort Lauderdale, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| Moore Ronald EDr. | Treasurer | 2307 West Broward Blvd, Fort Lauderdale, FL, 33312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-10-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-11-08 | 2307 West Broward Blvd, Suite 101, Fort Lauderdale, FL 33312 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-11-08 | 2307 West Broward Blvd, Suite 101, Fort Lauderdale, FL 33312 | No data |
| REINSTATEMENT | 2023-11-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-12-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2021-10-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000155440 | TERMINATED | 1000000948560 | BROWARD | 2023-04-05 | 2033-04-12 | $ 464.14 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J11000553854 | LAPSED | 10-20167 (04) | BROWARD COUNTY COURT | 2011-08-05 | 2016-08-30 | $24,844.50 | HCA PHYSICIAN SERVICES, INC., ONE PARK PLAZA, NASHVILLE, TN 37203 |
| J11000413836 | LAPSED | 10-20167 (04) | BROWARD COUNTY | 2011-06-03 | 2016-07-05 | $50,233.02 | HCA PHYSICIAN SERVICES, INC., ONE PARK PLAZA, NASHVILLE, TN 37203 |
| J10000594561 | TERMINATED | 1000000172629 | BROWARD | 2010-05-12 | 2030-05-19 | $ 367.65 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-10-28 |
| REINSTATEMENT | 2023-11-08 |
| REINSTATEMENT | 2022-12-17 |
| REINSTATEMENT | 2021-10-12 |
| REINSTATEMENT | 2020-10-16 |
| REINSTATEMENT | 2019-10-20 |
| ANNUAL REPORT | 2018-08-02 |
| ANNUAL REPORT | 2017-07-06 |
| REINSTATEMENT | 2016-10-27 |
| REINSTATEMENT | 2015-10-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
