| Entity Name: | JACOB & JACOB MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 11 Jul 2012 (13 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P12000060948 |
| Address: | 2101 NE 26 ST, FT LAUDERDALE, FL 33305 |
| Mail Address: | 2101 NE 26 ST, FT LAUDERDALE, FL 33305 |
| ZIP code: | 33305 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275793564 | 2008-06-11 | 2008-06-11 | 2101 NE 26TH ST, WILTON MANORS, FL, 333051535, US | 2101 NE 26TH STREET, FORT LAUDERDALE, FL, 33305, US | |||||||||||||||||||
|
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| Phone | +1 954-564-8542 |
| Fax | 9545643364 |
Authorized person
| Name | MIREILLE COLES |
| Role | PHYSICIAN |
| Phone | 9545648542 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME34383 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COLES, MIREILLE | Agent | 2101 NE 26 ST, FT LAUDERDALE, FL 33305 |
| Name | Role | Address |
|---|---|---|
| COLES, MIREILLE | President | 2101 NE 26 ST, FT LAUDERDALE, FL 33305 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2012-07-11 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
