| Entity Name: | OBGYN OF MIRAMAR, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 May 2017 (8 years ago) |
| Document Number: | P17000044660 |
| FEI/EIN Number | 82-1880300 |
| Address: | 601 N. FLAMINGO ROAD, SUITE 305, PEMBROKE PINES, FL, 33028, US |
| Mail Address: | 3541 SW 142ND AVE, MIRAMAR, FL, 33027, US |
| ZIP code: | 33028 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265946511 | 2017-11-23 | 2022-07-21 | 3541 SW 142ND AVE, MIRAMAR, FL, 330274705, US | 601 N FLAMINGO RD STE 305, PEMBROKE PINES, FL, 330281010, US | |||||||||||||||||||
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| Phone | +1 239-738-1455 |
| Phone | +1 866-236-2906 |
Authorized person
| Name | DR. DIMITRI P LOPEZ LINNIKOV |
| Role | OB/GYN |
| Phone | 2397381455 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME115729 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LOPEZ LINNIKOV DIMITRI PDR | Agent | 3541 SW 142ND AVE, MIRAMAR, FL, 33027 |
| Name | Role | Address |
|---|---|---|
| LOPEZ LINNIKOV DIMITRI PDR | President | 3541 SW 142ND AVE, MIRAMAR, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-24 | 601 N. FLAMINGO ROAD, SUITE 305, PEMBROKE PINES, FL 33028 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-01-12 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-06 |
| Domestic Profit | 2017-05-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
