| Entity Name: | CANTAVE FAMILY MEDICINE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Sep 2010 (14 years ago) |
| Date of dissolution: | 27 Sep 2018 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Sep 2018 (6 years ago) |
| Document Number: | P10000079336 |
| FEI/EIN Number | 273573630 |
| Address: | 8880 Royal Palm Blvd, Coral Springs, FL, 33065, US |
| Mail Address: | 8880 Royal Palm Blvd, Coral Springs, FL, 33065, US |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245571298 | 2013-03-14 | 2013-03-14 | 8880 ROYAL PALM BLVD, SUITE 105, CORAL SPRINGS, FL, 330655727, US | 8880 ROYAL PALM BLVD, SUITE 105, CORAL SPRINGS, FL, 330655727, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 954-255-8128 |
| Fax | 9542558130 |
Authorized person
| Name | DR. HUBERT J CANTAVE |
| Role | MEDICAL DIRECTOR |
| Phone | 9542558128 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME87727 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 270853100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CONZE KERTCH J | Agent | 3600 RED ROAD, MIRAMAR, FL, 33025 |
| Name | Role | Address |
|---|---|---|
| CANTAVE HUBERT JMD | President | 5311 BUCKHEAD CIRCLE, BOCA RATON, FL, 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-27 | 8880 Royal Palm Blvd, Suite 105, Coral Springs, FL 33065 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-27 | 8880 Royal Palm Blvd, Suite 105, Coral Springs, FL 33065 | No data |
| AMENDMENT AND NAME CHANGE | 2012-07-19 | CANTAVE FAMILY MEDICINE, P.A. | No data |
| REGISTERED AGENT NAME CHANGED | 2012-07-19 | CONZE, KERTCH JESQ. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-07-19 | 3600 RED ROAD, SUITE 402, MIRAMAR, FL 33025 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15000080529 | LAPSED | CACE14-004553 | 17TH JUDICIAL, BROWARD COUNTY | 2015-01-07 | 2020-01-20 | $279,150.99 | JPMORGAN CHASE BANK, N.A., 1111 POLARIS PARKWAY, COLUMBUS, OH 43240 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-01-19 |
| ANNUAL REPORT | 2014-02-27 |
| ANNUAL REPORT | 2013-01-11 |
| Off/Dir Resignation | 2012-08-08 |
| Amendment and Name Change | 2012-07-19 |
| ANNUAL REPORT | 2012-05-07 |
| ANNUAL REPORT | 2011-01-27 |
| Domestic Profit | 2010-09-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
