| Entity Name: | BLAKE TISHMAN, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Mar 2012 (13 years ago) |
| Document Number: | P12000026327 |
| FEI/EIN Number | 45-4901806 |
| Address: | 6662 Parkside Drive, Parkland, FL, 33067, US |
| Mail Address: | 9155 Ramblewood Drive, Coral Springs, FL, 33071, US |
| ZIP code: | 33067 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134515125 | 2015-04-07 | 2023-03-23 | 9155 RAMBLEWOOD DR APT 317, CORAL SPRINGS, FL, 330717036, US | 750 E SAMPLE RD STE 3-4, POMPANO BEACH, FL, 330645138, US | |||||||||||||||||||
|
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| Phone | +1 561-576-7740 |
| Fax | 5615767783 |
Authorized person
| Name | DR. BLAKE TISHMAN |
| Role | OWNER |
| Phone | 5615767740 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10137 |
| State | ZZ |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TISHMAN BLAKE | Agent | 9155 Ramblewood Drive, Coral Springs, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| Tishman Blake | President | 9155 Ramblewood Drive, Coral Springs, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| TISHMAN JERRY | Treasurer | 8177 WEST GLADES RD., SUITE 24, BOCA RATON, FL, 33434 |
| Name | Role | Address |
|---|---|---|
| TISHMAN JERRY | Secretary | 8177 WEST GLADES RD., SUITE 24, BOCA RATON, FL, 33434 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-09 | 6662 Parkside Drive, Parkland, FL 33067 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-21 | 6662 Parkside Drive, Parkland, FL 33067 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-21 | 9155 Ramblewood Drive, Apt. 317, Coral Springs, FL 33071 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
