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PETERSEN MEDICAL CORP - Florida Company Profile

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Company Details

Entity Name: PETERSEN MEDICAL CORP
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 07 Jul 2017 (8 years ago)
Date of dissolution: 25 Sep 2020 (5 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2020 (5 years ago)
Document Number: P17000058355
FEI/EIN Number 82-2094030
Address: 284 S. UNIVERSITY DR., PLANTATION, FL, 33324
Mail Address: 284 S. UNIVERSITY DR., PLANTATION, FL, 33324
ZIP code: 33324
City: Fort Lauderdale
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PETERSEN KYLE President 4415 PARKSIDE RD, DAVIE, FL, 33328
PETERSEN KYLE Agent 284 S. UNIVERSITY DR, PLANTATION, FL, 33324

National Provider Identifier

NPI Number:
1891293668

Authorized Person:

Name:
KYLE PETERSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QR0400X - Rehabilitation Clinic/Center
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3056405705

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 - -
CHANGE OF PRINCIPAL ADDRESS 2018-11-19 284 S. UNIVERSITY DR., PLANTATION, FL 33324 -
CHANGE OF MAILING ADDRESS 2018-11-19 284 S. UNIVERSITY DR., PLANTATION, FL 33324 -
REGISTERED AGENT NAME CHANGED 2018-11-19 PETERSEN, KYLE -
REGISTERED AGENT ADDRESS CHANGED 2018-11-19 284 S. UNIVERSITY DR, PLANTATION, FL 33324 -
AMENDMENT 2017-07-24 - -

Documents

Name Date
ANNUAL REPORT 2019-04-03
Reg. Agent Change 2018-11-19
ANNUAL REPORT 2018-01-29
Amendment 2017-07-24
Domestic Profit 2017-07-07

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Date of last update: 02 Aug 2025

Sources: Florida Department of State