| Entity Name: | MICHAEL N FUNK MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 May 2018 (7 years ago) |
| Date of dissolution: | 27 Jun 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Jun 2018 (7 years ago) |
| Document Number: | P18000040670 |
| Address: | 3001 CORAL HILLS DRIVE, 340, CORAL SPRINGS, FL, 33065 |
| Mail Address: | 3001 CORAL HILLS DRIVE, 340, CORAL SPRINGS, FL, 33065 |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225273949 | 2008-12-09 | 2011-09-12 | 2960 N STATE ROAD 7, 102, MARGATE, FL, 330635755, US | 2960 N STATE ROAD 7, 102, MARGATE, FL, 330635755, US | |||||||||||||||||||||||||
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| Phone | +1 954-973-1880 |
| Fax | 9549731882 |
Authorized person
| Name | DR. MICHAEL N FUNK |
| Role | PRESIDENT |
| Phone | 9549731880 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME95185 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000432000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOFSEN HOWARD | Agent | 5541 N UNIVERSITY DR, CORAL SPRINGS, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| FUNK MICHAEL N | President | 3001 CORAL HILLS DR, STE 340, CORAL SPRINGS, FL, 33065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-06-27 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2018-05-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
