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BROWARD HEALTH MEDICAL GROUP, INC. - Florida Company Profile

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Company Details

Entity Name: BROWARD HEALTH MEDICAL GROUP, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 14 Oct 2013 (12 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 08 Jul 2021 (4 years ago)
Document Number: P13000084112
FEI/EIN Number NOT APPLICABLE
Address: 7539-41 WEST OAKLAND PARK BLVD, LAUDERHILL, FL, 33319, US
Mail Address: 7539-41 WEST OAKLAND PARK BLVD, LAUDERHILL, FL, 33319, US
ZIP code: 33319
City: Fort Lauderdale
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
AMISIAL JEAN M President 6415 Osprey Landing St., DAVID, FL, 33314
SANOZIER ROCK Manager 4770 NW 9TH CT, PLANTATION, FL, 33317
AMISIAL JEAN MDr. Agent 7539-41 WEST OAKLAND PARK BLVD, LAUDERHILL, FL, 33319

National Provider Identifier

NPI Number:
1568197994
Certification Date:
2023-01-17

Authorized Person:

Name:
DR. SHANNA STEPHEN
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
7542232836

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000079178 CENTRIC FAMILY MED & REHAB ACTIVE 2022-07-01 2027-12-31 - 5979 VINELAND ROAD, SUITE 214, ORLANDO FL, FL, 32819

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-09-12 AMISIAL, JEAN MICHEL, Dr. -
REINSTATEMENT 2021-07-08 - -
CHANGE OF PRINCIPAL ADDRESS 2021-07-08 7539-41 WEST OAKLAND PARK BLVD, LAUDERHILL, FL 33319 -
CHANGE OF MAILING ADDRESS 2021-07-08 7539-41 WEST OAKLAND PARK BLVD, LAUDERHILL, FL 33319 -
REGISTERED AGENT ADDRESS CHANGED 2021-07-08 7539-41 WEST OAKLAND PARK BLVD, LAUDERHILL, FL 33319 -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2014-09-26 - -

Documents

Name Date
ANNUAL REPORT 2024-05-01
ANNUAL REPORT 2023-09-12
AMENDED ANNUAL REPORT 2022-09-27
ANNUAL REPORT 2022-02-07
AMENDED ANNUAL REPORT 2021-08-23
REINSTATEMENT 2021-07-08
Domestic Profit 2013-10-14
Off/Dir Resignation 2013-10-14

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Date of last update: 01 Aug 2025

Sources: Florida Department of State