| Entity Name: | ANDREW R ALTMAN MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Jan 2008 (17 years ago) |
| Date of dissolution: | 23 Aug 2023 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 23 Aug 2023 (a year ago) |
| Document Number: | P08000009760 |
| FEI/EIN Number | 261872452 |
| Mail Address: | 4000 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021, US |
| Address: | 137 NW 100TH AVE, PLANTATION, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548436710 | 2008-05-07 | 2009-09-15 | 137 NW 100TH AVE, PLANTATION, FL, 333247034, US | 137 NW 100TH AVE, PLANTATION, FL, 333247034, US | |||||||||||||||||||||||||
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| Phone | +1 954-577-5161 |
| Fax | 9545775191 |
Authorized person
| Name | ANDREW ROBERT ALTMAN |
| Role | PRESIDENT |
| Phone | 9545775161 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | ME51770 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI 1689746356 |
| Number | ME 51770 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| ALTMAN MD ANDREW R | President | 3740 S Ocean Blvd, Highland Beach, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| Altman Patricia A | Treasurer | 3740 S Ocean Blvd, Highland Beach, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| Schillinger Jeffrey | Chief Executive Officer | 4000 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000170552 | PLANTATION DERMATOLOGY | ACTIVE | 2021-12-23 | 2026-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-08-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-24 | C T Corporation System | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-24 | 1200 South Pine Island Road, Plantation, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-27 | 137 NW 100TH AVE, PLANTATION, FL 33324 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-20 | 137 NW 100TH AVE, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-08-23 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-18 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
