| Entity Name: | MIVIP MEDICAL GROUP INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 13 Feb 2013 (12 years ago) |
| Date of dissolution: | 28 Dec 2023 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Dec 2023 (a year ago) |
| Document Number: | P13000014633 |
| FEI/EIN Number | 46-2120888 |
| Mail Address: | 398 CAMINO GARDENS BLVD, SUITE 102, BOCA RATON, FL 33432 |
| Address: | 398 CAMINO GARDENS BLVD., 102, Suite #2004, Boca Raton, FL 33432 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477996544 | 2013-04-09 | 2015-01-13 | 398 CAMINO GARDENS BLVD, SUITE 102, BOCA RATON, FL, 334325827, US | 351 NW 42ND AVE, SUITE 408, MIAMI, FL, 331265683, US | |||||||||||||||||||
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| Phone | +1 561-392-3341 |
Authorized person
| Name | ISAAC VERBUKH |
| Role | OWBER |
| Phone | 5613923341 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBSFL |
| Number | 004L9 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WHALEN, KENNETH E | Agent | 398 CAMINO GARDENS BLVD, SUITE 102, BOCA RATON, FL 33432 |
| Name | Role | Address |
|---|---|---|
| VERBUKH, ISAAC MD | Director | 398 CAMINO GARDENS BLVD SUITE 102, BOCA RATON, FL 33432 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000038906 | OBAND MEDICAL GROUP | EXPIRED | 2013-04-23 | 2018-12-31 | No data | 398 CAMINO GARDENS BLVD., SUITE 102, BOCA RATON, FL, 33432 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-12-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-04 | 398 CAMINO GARDENS BLVD., 102, Suite #2004, Boca Raton, FL 33432 | No data |
| CHANGE OF MAILING ADDRESS | 2016-03-09 | 398 CAMINO GARDENS BLVD., 102, Suite #2004, Boca Raton, FL 33432 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-12-28 |
| ANNUAL REPORT | 2023-03-24 |
| ANNUAL REPORT | 2022-04-04 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-03-04 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-04-27 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
