| Entity Name: | BRIAN B. IBRAHIM, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Sep 2011 (13 years ago) |
| Document Number: | P11000085499 |
| FEI/EIN Number | 453504630 |
| Address: | 2807 NE 28th Street, Fort lauderdale, FL, 33306, US |
| Mail Address: | 2807 NE 28th Street, Fort lauderdale, FL, 33306, US |
| ZIP code: | 33306 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073897195 | 2011-10-07 | 2011-10-07 | 2950 NE 188TH ST, #311, AVENTURA, FL, 331802708, US | 4200 WASHINGTON ST, HOLLYWOOD, FL, 330217353, US | |||||||||||||||
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| Phone | +1 954-647-2326 |
| Phone | +1 954-981-6300 |
Authorized person
| Name | BRIAN B IBRAHIM |
| Role | PRESIDENT |
| Phone | 9546472326 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| IBRAHIM BRIAN B | Agent | 2807 NE 28th Street, Fort lauderdale, FL, 33306 |
| Name | Role | Address |
|---|---|---|
| IBRAHIM BRIAN B | President | 2807 NE 28th Street, Fort Lauderdale, FL, 33306 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-23 | 2807 NE 28th Street, Fort lauderdale, FL 33306 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-23 | 2807 NE 28th Street, Fort lauderdale, FL 33306 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-23 | 2807 NE 28th Street, Fort lauderdale, FL 33306 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-24 |
| ANNUAL REPORT | 2019-04-21 |
| ANNUAL REPORT | 2018-04-28 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
