| Entity Name: | JUSTIN YOVINO, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jul 2009 (16 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P09000064356 |
| FEI/EIN Number | 270644474 |
| Address: | 3201 N FEDERAL HWY STE 302, FORT LAUDERDALE, FL, 33306 |
| Mail Address: | 635 EUCLID AVE #115, MIAMI BEACH, FL, 33139 |
| ZIP code: | 33306 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154652824 | 2010-01-20 | 2010-01-20 | 910 NE 26TH AVE, FORT LAUDERDALE, FL, 333043607, US | 910 NE 26TH AVE, FORT LAUDERDALE, FL, 333043607, US | |||||||||||||||||||||||||
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| Phone | +1 954-565-2330 |
| Fax | 9545658994 |
Authorized person
| Name | DR. JUSTIN YOVINO |
| Role | PRESIDENT |
| Phone | 9545652330 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | ME103236 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001345900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YOVINO JUSTIN M | Agent | 3201 N FEDERAL HWY STE 302, FORT LAUDERDALE, FL, 33306 |
| Name | Role | Address |
|---|---|---|
| YOVINO JUSTIN M | President | 910 NE 26TH AVENUE, FORT LAUDERDALE, FL, 33304 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-09-10 | 3201 N FEDERAL HWY STE 302, FORT LAUDERDALE, FL 33306 | No data |
| CHANGE OF MAILING ADDRESS | 2012-09-10 | 3201 N FEDERAL HWY STE 302, FORT LAUDERDALE, FL 33306 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-09-10 | 3201 N FEDERAL HWY STE 302, FORT LAUDERDALE, FL 33306 | No data |
| Name | Date |
|---|---|
| Reg. Agent Change | 2012-09-10 |
| ANNUAL REPORT | 2012-02-12 |
| ANNUAL REPORT | 2011-01-05 |
| ANNUAL REPORT | 2010-02-18 |
| Domestic Profit | 2009-07-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
