| Entity Name: | MARYAM JAFARIEH, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Dec 2004 (20 years ago) |
| Document Number: | P04000163477 |
| FEI/EIN Number | 201958801 |
| Address: | 1919 NE 45TH STREET, FORT LAUDERDALE, FL, 33308, US |
| Mail Address: | 1919 NE 45TH STREET, FORT LAUDERDALE, FL, 33308, US |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285942094 | 2010-09-15 | 2016-09-23 | 5165 NW 11TH LANE, POMPANO BEACH, FL, 330648621, US | 1515 EAST COMMERCIAL BLVD., FORT LAUDERDALE, FL, 33334, US | |||||||||||||||||||||||
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| Phone | +1 954-229-1995 |
| Fax | 9542291996 |
Authorized person
| Name | MARYAM JAFARIEH |
| Role | PRESIDENT |
| Phone | 9545544662 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8598 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CAQH |
| Number | 12146914 |
| Name | Role | Address |
|---|---|---|
| RAY PEREZ & ASSOCIATES PA | Agent | 13935 NW 1ST AVE, MIAMI, FL, 33168 |
| Name | Role | Address |
|---|---|---|
| JAFARIEH MARYAM | President | 1919 NE 45TH STREET, FORT LAUDERDALE, FL, 33308 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000023352 | FT. LAUDERDALE CHIROPRACTIC | ACTIVE | 2023-02-19 | 2028-12-31 | No data | 1919 NE 45TH STREET., STE 219, FORT LAUDERDALE, FL, 33308 |
| G12000103464 | FT. LAUDERDALE CHIROPRACTIC | EXPIRED | 2012-10-24 | 2017-12-31 | No data | 1515 EAST COMMERCIAL BLVD., FORT LAUDERDALE, FL, 33334 |
| G12000103469 | RELAXATION & BODYWORKS STUDIO | EXPIRED | 2012-10-24 | 2017-12-31 | No data | 1515 EAST COMMERCIAL BLVD., FORT LAUDERDALE, FL, 33334 |
| G11000019563 | FT LAUDERDALE CHIROPRACTIC WHIPLASH INJURY RELIEF CENTER | EXPIRED | 2011-02-22 | 2016-12-31 | No data | 1515 EAST COMMERCIAL BLVD, FT LAUDERDALE, FL, 33334 |
| G08364900206 | SMART HEALTH INC | EXPIRED | 2008-12-29 | 2013-12-31 | No data | 2817 EAST OAKLAND PARK BLVD, SUIT # 200-B, FORT LAUDERDALE, FL, 33306 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-07 | 1919 NE 45TH STREET, 219, FORT LAUDERDALE, FL 33308 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-07 | 1919 NE 45TH STREET, 219, FORT LAUDERDALE, FL 33308 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-15 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-03-01 |
| ANNUAL REPORT | 2017-03-14 |
| ANNUAL REPORT | 2016-02-19 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
