| Entity Name: | SERGIO A. BELTRAN, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Mar 2006 (19 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P06000030870 |
| FEI/EIN Number | 204546167 |
| Address: | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| Mail Address: | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043303605 | 2006-10-02 | 2008-04-20 | 4542 SW 124TH TER, MIRAMAR, FL, 330273127, US | 4542 SW 124TH TER, MIRAMAR, FL, 330273127, US | |||||||||||||||||
|
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| Phone | +1 305-829-5653 |
Authorized person
| Name | SERGIO A BELTRAN |
| Role | PRESIDENT |
| Phone | 7863381102 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME88820 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BELTRAN SERGIO A | Agent | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| BELTRAN SERGIO A | President | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| BELTRAN SERGIO A | Secretary | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| BELTRAN SERGIO A | Treasurer | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| BELTRAN SERGIO A | Director | 1558 SW 189 TERRACE, MIRAMAR, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-30 | 1558 SW 189 TERRACE, MIRAMAR, FL 33029 | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-30 | 1558 SW 189 TERRACE, MIRAMAR, FL 33029 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-04-30 | BELTRAN, SERGIO A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-30 | 1558 SW 189 TERRACE, MIRAMAR, FL 33029 | No data |
| NAME CHANGE AMENDMENT | 2007-05-11 | SERGIO A. BELTRAN, MD PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-04-15 |
| ANNUAL REPORT | 2008-04-30 |
| Name Change | 2007-05-11 |
| ANNUAL REPORT | 2007-05-08 |
| Domestic Profit | 2006-03-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
