| Entity Name: | JEROME R. OBED, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 May 2006 (19 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 09 Nov 2008 (16 years ago) |
| Document Number: | P06000073820 |
| FEI/EIN Number | 20-4993285 |
| Address: | 500 SE 15TH STREET, SUITE #108, FORT LAUDERDALE, FL, 33316 |
| Mail Address: | 500 SE 15TH STREET, SUITE #108, FORT LAUDERDALE, FL, 33316 |
| ZIP code: | 33316 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063760502 | 2012-08-15 | 2014-05-13 | 500 SE 15TH ST, SUITE 108, FT LAUDERDALE, FL, 333161952, US | 500 SE 15TH ST, SUITE 108, FT LAUDERDALE, FL, 333161952, US | |||||||||||||||||||||
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| Phone | +1 954-990-6591 |
Authorized person
| Name | DR. JEROME R OBED |
| Role | PRESIDENT |
| Phone | 9549906591 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MOFSEN HOWARD J | Agent | 9728 WEST SAMPLE ROAD, CORAL SPRINGS, FL, 33065 |
| Name | Role | Address |
|---|---|---|
| OBED JEROME R | Director | 500 SE 15TH STREET, FORT LAUDERDALE, FL, 33316 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000077144 | BROWARD DERMATOLOGY AND COSMETIC SPECIALISTS | ACTIVE | 2012-08-03 | 2027-12-31 | No data | 500 SE 15 STREET, 108, FORT LAUDERDALE, FL, 33316 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-27 | 500 SE 15TH STREET, SUITE #108, FORT LAUDERDALE, FL 33316 | No data |
| CHANGE OF MAILING ADDRESS | 2012-08-27 | 500 SE 15TH STREET, SUITE #108, FORT LAUDERDALE, FL 33316 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-08-27 | 9728 WEST SAMPLE ROAD, CORAL SPRINGS, FL 33065 | No data |
| CANCEL ADM DISS/REV | 2008-11-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-12 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-01-15 |
| ANNUAL REPORT | 2018-01-04 |
| ANNUAL REPORT | 2017-01-24 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-02-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
