URGENT CARE AND SURGERY CENTER OF FORT LAUDERDALE, INC. - Florida Company Profile

Key Officers & Management

Name	Role	Address
BOGDAN MICHAEL	Director	2040 NORTHEAST 49TH STREET, FORT LAUDERDALE, FL, 33308
ROSEN GENE S	Agent	1550 NE MIAMI GARDENS DRIVE, MIAMI BEACH, FL, 33179
BELLINA RYAN	Director	2040 NORTHEAST 49TH STREET, FORT LAUDERDALE, FL, 33308

National Provider Identifier

Authorized Person:

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Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G11000039314	OPTIMA HEALTH & DIAGNOSTICS	EXPIRED	2011-04-22	2016-12-31	-	2040 NE 49TH STREET, FORT LAUDERDALE, FL, 33308
G10000052804	INTEGRATED MEDICAL GROUP	EXPIRED	2010-06-11	2015-12-31	-	2040 NE 49TH STREET, FORT LAUDERDALE, FL, 33308

Events

Event Type	Filed Date	Value	Description
ADMIN DISSOLUTION FOR ANNUAL REPORT	2013-09-27	-	-
CHANGE OF PRINCIPAL ADDRESS	2012-03-26	2040 NORTHEAST 49TH STREET, FORT LAUDERDALE, FL 33308	-
CHANGE OF MAILING ADDRESS	2012-03-26	2040 NORTHEAST 49TH STREET, FORT LAUDERDALE, FL 33308	-
AMENDMENT	2011-06-28	-	-
REGISTERED AGENT NAME CHANGED	2010-03-18	ROSEN, GENE SATTY	-
REGISTERED AGENT ADDRESS CHANGED	2010-03-18	1550 NE MIAMI GARDENS DRIVE, SUITE 305, MIAMI BEACH, FL 33179	-

Debts

Document Number	Status	Case Number	Name of Court	Date of Entry	Expiration Date	Amount Due	Plaintiff
J14000056688	LAPSED	1000000570111	BROWARD	2014-01-02	2024-01-09	$ 638.31	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149
J12000462591	LAPSED	COSO-11-008967	HOLLYWOOD, BROWARD COUNTY, FL	2011-12-14	2017-06-04	$2425.00	PAUL SHLUGMAN, 16737 NE 35 AVE., UNIT 3, NORTH MIAMI BEACH, FL, 33160

Documents

Name	Date
ANNUAL REPORT	2012-03-26
Off/Dir Resignation	2011-10-13
Amendment	2011-06-28
ANNUAL REPORT	2011-02-16
ANNUAL REPORT	2010-09-18
ANNUAL REPORT	2010-06-11
ANNUAL REPORT	2010-03-18
Domestic Profit	2009-07-23