| Entity Name: | BART K. GERSHENBAUM D.O., INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 May 2006 (19 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P06000069011 |
| FEI/EIN Number | 87-0771076 |
| Address: | 4301 S. FLAMINGO RD, SUITE 106/218, DAVIE, FL 33330 |
| Mail Address: | 4301 S. FLAMINGO RD, SUITE 106/218, DAVIE, FL 33330 |
| ZIP code: | 33330 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508277518 | 2014-05-13 | 2014-05-13 | 7750 NOVA DR, DAVIE, FL, 33324, US | 7750 NOVA DR, DAVIE, FL, 33324, US | |||||||||||||||||||||||||
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| Phone | +1 954-634-3438 |
| Fax | 9546343437 |
Authorized person
| Name | DR. BART K GERSHENBAUM |
| Role | OWNER,PRESIDENT |
| Phone | 9546343438 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS4663 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FAMILY MEDICINE |
| Number | 1043237514 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GERSHENBAUM, BART K | Agent | 4301 S. FLAMINGO RD, SUITE 106/218, DAVIE, FL 33330 |
| Name | Role | Address |
|---|---|---|
| GERSHENBAUM, BART K | President | 4301 S. FLAMINGO RD SUITE 106/218, DAVIE, FL 33330 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2016-03-29 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-03-29 | GERSHENBAUM, BART K | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-30 | 4301 S. FLAMINGO RD, SUITE 106/218, DAVIE, FL 33330 | No data |
| REINSTATEMENT | 2014-04-30 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-30 | 4301 S. FLAMINGO RD, SUITE 106/218, DAVIE, FL 33330 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-30 | 4301 S. FLAMINGO RD, SUITE 106/218, DAVIE, FL 33330 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CANCEL ADM DISS/REV | 2009-08-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-04-09 |
| ANNUAL REPORT | 2019-05-14 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-04-27 |
| REINSTATEMENT | 2016-03-29 |
| REINSTATEMENT | 2014-04-30 |
| ANNUAL REPORT | 2012-02-06 |
| ANNUAL REPORT | 2011-05-01 |
| ANNUAL REPORT | 2010-09-14 |
Date of last update: 28 Jan 2025
Sources: Florida Department of State
