| Entity Name: | FLORIDA HEALTH MANAGEMENT GROUP, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Apr 2013 (12 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P13000034605 |
| FEI/EIN Number | 270669633 |
| Address: | 1920 E HALLANDALE BEACH BLVD, #807, HALLANDALE BEACH, FL, 33009 |
| Mail Address: | 1920 E HALLANDALE BEACH BLVD, #807, HALLANDALE BEACH, FL, 33009 |
| ZIP code: | 33009 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1801122940 | 2009-10-25 | 2014-01-28 | 1920 E HALLANDALE BEACH BLVD, 503, HALLANDALE BEACH, FL, 330094722, US | 1920 E HALLANDALE BEACH BLVD, 503, HALLANDALE BEACH, FL, 330094722, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-331-2798 |
| Fax | 9549443181 |
Authorized person
| Name | MR. ROBERT VIERA |
| Role | PRESIDENT |
| Phone | 3053312798 |
Taxonomy
| Taxonomy Code | 133N00000X - Nutritionist |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME50277 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | ME50277 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME50277 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME50277 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| License Number | PA 9103525 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| License Number | PA 9103525 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICARE ID-TYPE UNSPECIFIED |
| Number | 05653 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VIERA ROBERT K | Agent | 1920 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL, 33009 |
| Name | Role | Address |
|---|---|---|
| VIERA ROBERT K | President | 1920 E HALLANDALE BEACH BLVD #807, HALLANDALE BEACH, FL, 33009 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000857036 | LAPSED | 1000000624086 | BROWARD | 2014-05-08 | 2024-08-01 | $ 761.72 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| J14000101393 | TERMINATED | 1000000574646 | BROWARD | 2014-01-13 | 2034-01-15 | $ 4,341.14 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| Name | Date |
|---|---|
| Domestic Profit | 2013-04-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
