| Entity Name: | MIRZA MEDICAL PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Apr 2017 (8 years ago) |
| Document Number: | P17000036417 |
| FEI/EIN Number | 82-1300066 |
| Address: | 3021 NE 44 ST, FT. LAUDERDALE, FL 33308 |
| Mail Address: | 3021 NE 44 ST, FT. LAUDERDALE, FL 33308 |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851820922 | 2017-06-12 | 2017-06-12 | 3021 NE 44TH ST, FORT LAUDERDALE, FL, 333085307, US | 3075 NW 35TH AVE, LAUDERDALE LAKES, FL, 333111107, US | |||||||||||||||||
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| Phone | +1 305-891-8850 |
Authorized person
| Name | KHURRAM MIRZA |
| Role | OWNER |
| Phone | 9543355500 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME122105 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| THE KLEIN GROUP CPA PA | Agent | 2300 NW CORPORATE BLVD, 112, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| MIRZA, KHURRAM | President | 3021 NE 44 ST, FT. LAUDERDALE, FL 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-26 | 2300 NW CORPORATE BLVD, 112, BOCA RATON, FL 33431 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-03-31 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-26 |
| Domestic Profit | 2017-04-21 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
