| Entity Name: | BASSEL IBRAHIM MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Apr 2014 (11 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P14000035635 |
| FEI/EIN Number | 46-5438533 |
| Address: | 2591 SW 102ND DRIVE, DAVIE, FL, 33324 |
| Mail Address: | 2591 SW 102ND DRIVE, DAVIE, FL, 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134531759 | 2014-06-02 | 2014-08-26 | 1150 N 35TH AVE, SUITE 240, HOLLYWOOD, FL, 330215424, US | 1150 N 35TH AVE, SUITE 240, HOLLYWOOD, FL, 330215424, US | |||||||||||||||||||
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| Phone | +1 954-362-3426 |
| Fax | 9549618733 |
Authorized person
| Name | DR. BASSEL B IBRAHIM |
| Role | OWNER |
| Phone | 9543623426 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME51232 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| IBRAHIM BASSEL B | Agent | 2591 SW 102ND DRIVE, DAVIE, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| IBRAHIM BASSEL B | President | 2591 SW 102ND DRIVE, DAVIE, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-18 |
| ANNUAL REPORT | 2015-04-26 |
| Domestic Profit | 2014-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
