| Entity Name: | MICHAEL A. CHIZNER, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 May 2018 (7 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P18000048754 |
| FEI/EIN Number | 83-0717366 |
| Address: | 620 2nd Key Drive, FT LAUDERDALE, FL, 33304, US |
| Mail Address: | 620 2nd Key Drive, FT LAUDERDALE, FL, 33304, US |
| ZIP code: | 33304 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144712050 | 2018-06-06 | 2018-10-29 | 12 NE 12TH AVE, FORT LAUDERDALE, FL, 333011604, US | 12 NE 12TH AVE, FORT LAUDERDALE, FL, 333011604, US | |||||||||||||||
|
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| Phone | +1 754-779-7150 |
| Phone | +1 954-463-3416 |
Authorized person
| Name | DR. MICHAEL A CHIZNER |
| Role | PRESIDENT |
| Phone | 7547797150 |
Taxonomy
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ROSEN KAREN Z | Agent | 370 MINORCA AVE, CORAL GABLES, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| CHIZNER MICHAEL AMD | President | 620 2nd Key Drive, FT LAUDERDALE, FL, 33304 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-29 | 620 2nd Key Drive, FT LAUDERDALE, FL 33304 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-29 | 620 2nd Key Drive, FT LAUDERDALE, FL 33304 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-03-29 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-07-25 |
| Domestic Profit | 2018-05-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
