| Entity Name: | URGENT CARE OF FORT LAUDERDALE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Jun 2013 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 20 Dec 2022 (2 years ago) |
| Document Number: | P13000048703 |
| FEI/EIN Number | 462925470 |
| Address: | 1820 EAST COMMERCIAL BOULEVARD, FORT LAUDERDALE, FL, 33308 |
| Mail Address: | PO BOX 11527, FORT LAUDERDALE, FL, 33339, US |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811335144 | 2013-06-09 | 2016-02-18 | 1820 E COMMERCIAL BLVD, FORT LAUDERDALE, FL, 333083725, US | 1820 E COMMERCIAL BLVD, FORT LAUDERDALE, FL, 333083725, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 954-368-3430 |
| Phone | +1 954-771-7900 |
| Fax | 9547716863 |
Authorized person
| Name | MR. ROBERT HIGGINS |
| Role | ADMIN |
| Phone | 9543683430 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009252400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MUNIM AMJAD MD | Agent | 1820 EAST COMMERCIAL BOULEVARD, FORT LAUDERDALE, FL, 33308 |
| Name | Role | Address |
|---|---|---|
| MUNIM AMJAD MD | President | 1820 EAST COMMERCIAL BOULEVARD, FORT LAUDERDALE, FL, 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-12-20 | MUNIM, AMJAD, MD | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-20 |
| REINSTATEMENT | 2022-12-20 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-04-16 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-07-20 |
| ANNUAL REPORT | 2017-02-21 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-02-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
