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MICHAEL D. BOEHM, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: MICHAEL D. BOEHM, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 03 Nov 2009 (16 years ago)
Date of dissolution: 28 Sep 2012 (13 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 28 Sep 2012 (13 years ago)
Document Number: P09000090720
FEI/EIN Number 271340372
Address: 1601 WEST REYNOLDS STREET SUITE 104, PLANT CITY, FL, 33563
Mail Address: 1601 WEST REYNOLDS STREET SUITE 104, PLANT CITY, FL, 33563
ZIP code: 33563
City: Plant City
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BOEHM MICHAEL Director 1601 WEST REYNOLDS STREET SUITE 104, PLANT CITY, FL, 33563
LANSKY GLEN R Agent LANSKY & COURTNEY, P.L., BRANDON, FL, 33511

National Provider Identifier

NPI Number:
1649593773

Authorized Person:

Name:
MICHAEL DANIEL BOEHM
Role:
OWNER / PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
8137525104

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 - -

Documents

Name Date
ANNUAL REPORT 2011-01-07
ANNUAL REPORT 2010-01-21
Domestic Profit 2009-11-03

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Date of last update: 01 Aug 2025

Sources: Florida Department of State