| 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 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 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 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891293668 | 2018-01-26 | 2018-01-26 | 7235 CORAL WAY STE 213, MIAMI, FL, 331551452, US | 7235 CORAL WAY STE 213, MIAMI, FL, 331551452, US | |||||||||||||||||||
|
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| Phone | +1 305-846-9303 |
| Fax | 3056405705 |
Authorized person
| Name | KYLE PETERSEN |
| Role | PRESIDENT |
| Phone | 3058469303 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| PETERSEN KYLE | Agent | 284 S. UNIVERSITY DR, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| PETERSEN KYLE | President | 4415 PARKSIDE RD, DAVIE, FL, 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-11-19 | 284 S. UNIVERSITY DR., PLANTATION, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2018-11-19 | 284 S. UNIVERSITY DR., PLANTATION, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-11-19 | PETERSEN, KYLE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-11-19 | 284 S. UNIVERSITY DR, PLANTATION, FL 33324 | No data |
| AMENDMENT | 2017-07-24 | No data | No data |
| 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 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
