| Entity Name: | IRIS VIVAS MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Mar 2014 (11 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P14000020033 |
| FEI/EIN Number | 46-5001883 |
| Address: | 1101 WATERSIDE LN, HOLLYWOOD, FL, 33019 |
| Mail Address: | 1101 WATERSIDE LN, HOLLYWOOD, FL, 33019 |
| ZIP code: | 33019 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144688029 | 2016-02-05 | 2016-02-05 | 1835 E HALLANDALE BEACH BLVD, SUITE 134, HALLANDALE BEACH, FL, 330094619, US | 1835 E HALLANDALE BEACH BLVD, SUITE 134, HALLANDALE BEACH, FL, 330094619, US | |||||||||||||||||||||||
|
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| Phone | +1 305-559-7996 |
Authorized person
| Name | IRIS VIVAS |
| Role | OWNER/PRESIDENT |
| Phone | 3055597996 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME107439 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | ME107439 |
| State | FL |
| Name | Role |
|---|---|
| THE LAW OFFICES OF MAX A. ADAMS, ESQ., PLLC | Agent |
| Name | Role | Address |
|---|---|---|
| VIVAS IRIS M | President | 1101 WATERSIDE LN, HOLLYWOOD, FL, 33019 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REINSTATEMENT | 2016-02-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-24 | LAW OFFICES OF MAX A ADAMS ESQ PLLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-02-24 | 2151 S LEJEUNE RD, SUITE 306, CORAL GABLES, FL 33134 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| ARTICLES OF CORRECT-ION/NAME CHANGE | 2014-03-11 | IRIS VIVAS MD PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-25 |
| REINSTATEMENT | 2016-02-24 |
| Article of Correction/NC | 2014-03-11 |
| Domestic Profit | 2014-03-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
