| Entity Name: | IMED SURGICAL OF MIAMI, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Sep 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 12 Jan 2024 (a year ago) |
| Document Number: | P19000071650 |
| FEI/EIN Number | 84-3102704 |
| Address: | 1820 E. Commercial Blvd., Room 3, Fort Lauderdale, FL, 33308, US |
| Mail Address: | 113 E 39TH STREET, NEW YORK, NY, 10016, US |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831749977 | 2019-09-19 | 2024-03-05 | PO BOX 1970, NEW YORK, NY, 101561970, US | 1820 E COMMERCIAL BLVD, FT LAUDERDALE, FL, 333083725, US | |||||||||||||||||
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| Phone | +1 631-760-1546 |
Authorized person
| Name | YVONNE DEACON |
| Role | RCM MANAGER |
| Phone | 6317601546 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NA |
| Number | NA |
| Name | Role | Address |
|---|---|---|
| HOLDING COMPANY OF LPS LLC | Agent | 1820 E. Commercial Blvd., Fort Lauderdale, FL, 33308 |
| Name | Role | Address |
|---|---|---|
| JONES MICHAEL EM.D. | President | 1820 E. Commercial Blvd., Fort Lauderdale, FL, 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-01-12 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-12 | 1820 E. Commercial Blvd., Room 3, Fort Lauderdale, FL 33308 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-12 | HOLDING COMPANY OF LPS LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-12 | 1820 E. Commercial Blvd., Room 3, Fort Lauderdale, FL 33308 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-01-12 |
| ANNUAL REPORT | 2020-06-08 |
| Domestic Profit | 2019-09-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
