| Entity Name: | RAUL DAZA, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Mar 2008 (17 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P08000024542 |
| FEI/EIN Number | 262214590 |
| Address: | 2132 Quail Roost Dr, Weston, FL, 33327, US |
| Mail Address: | 2132 Quail Roost Dr, Weston, FL, 33327, US |
| ZIP code: | 33327 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770755217 | 2008-03-25 | 2008-03-25 | 15951 SW 6TH ST, PEMBROKE PINES, FL, 330271161, US | 15951 SW 6TH ST, PEMBROKE PINES, FL, 330271161, US | |||||||||||||||||
|
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| Phone | +1 954-290-6727 |
Authorized person
| Name | RAUL DAZA |
| Role | OWNER |
| Phone | 9542906727 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME 96199 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAZA RAUL | Agent | 2132 Quail Roost Dr, Weston, FL, 33327 |
| Name | Role | Address |
|---|---|---|
| DAZA RAUL | President | 2132 Quail Roost Dr, Weston, FL, 33327 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-12 | 2132 Quail Roost Dr, Weston, FL 33327 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-12 | 2132 Quail Roost Dr, Weston, FL 33327 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-12 | 2132 Quail Roost Dr, Weston, FL 33327 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-22 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-01-13 |
| ANNUAL REPORT | 2013-01-18 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-01-09 |
| ANNUAL REPORT | 2010-01-12 |
| ANNUAL REPORT | 2009-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
