| Entity Name: | EDWIN A GOMEZ MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Mar 2011 (14 years ago) |
| Date of dissolution: | 14 Jul 2011 (14 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 14 Jul 2011 (14 years ago) |
| Document Number: | P11000022500 |
| Address: | 165 EAST BAYRIDGE DR, WESTON, FL, 33326 |
| Mail Address: | 165 EAST BAYRIDGE DR, WESTON, FL, 33326 |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093002420 | 2011-07-06 | 2011-07-06 | 1040 WESTON ROAD, SUITE 210, WESTON, FL, 333261912, US | 1040 WESTON ROAD, SUITE 210, WESTON, FL, 333261912, US | |||||||||||||||||
|
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| Phone | +1 954-604-3900 |
Authorized person
| Name | DR. EDWIN A GOMEZ |
| Role | OWNER |
| Phone | 9546043900 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME97741 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOMEZ EDWIN A | Agent | 165 EAST BAYRIDGE DR, WESTON, FL, 33326 |
| Name | Role | Address |
|---|---|---|
| GOMEZ EDWIN A | President | 165 EAST BAYRIDGE DR, WESTON, FL, 33326 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2011-07-14 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L11000081523. CONVERSION NUMBER 900000115129 |
| Name | Date |
|---|---|
| Domestic Profit | 2011-03-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
