| Entity Name: | FORT LAUDERDALE MEDICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 26 Oct 1992 (32 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | P92000000915 |
| FEI/EIN Number | 65-0366757 |
| Address: | 4300 N.W. 92ND TERRACE, CORAL SPRINGS, FL 33065 |
| Mail Address: | 4300 N.W. 92ND TERRACE, CORAL SPRINGS, FL 33065 |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609082387 | 2007-05-16 | 2020-08-22 | PO BOX 9494, CORAL SPRINGS, FL, 330759494, US | 4300 NW 92ND TER, CORAL SPRINGS, FL, 330651731, US | |||||||||||||||||||||||
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| Phone | +1 954-510-0333 |
| Fax | 9545100333 |
Authorized person
| Name | MR. ALAN G. LEFORT |
| Role | PRESIDENT |
| Phone | 9545100333 |
Taxonomy
| Taxonomy Code | 261QR0208X - Mobile Radiology Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUECROSSBLUESHIELD |
| Number | V1728 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEFORT, ALAN G | Agent | 4300 N.W. 92ND TERRACE, CORAL SPRINGS, FL 33065 |
| Name | Role | Address |
|---|---|---|
| LEFORT, ALAN | President | 4300 NW 92ND TERRACE, CORAL SPRINGS, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2006-12-21 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2002-04-29 | LEFORT, ALAN G | No data |
| CHANGE OF MAILING ADDRESS | 1997-01-22 | 4300 N.W. 92ND TERRACE, CORAL SPRINGS, FL 33065 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1994-04-26 | 4300 N.W. 92ND TERRACE, CORAL SPRINGS, FL 33065 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1994-04-26 | 4300 N.W. 92ND TERRACE, CORAL SPRINGS, FL 33065 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-09-13 |
| REINSTATEMENT | 2006-12-21 |
| ANNUAL REPORT | 2005-04-26 |
| ANNUAL REPORT | 2004-03-16 |
| ANNUAL REPORT | 2003-04-28 |
| ANNUAL REPORT | 2002-04-29 |
| ANNUAL REPORT | 2001-03-21 |
| ANNUAL REPORT | 2000-04-24 |
| ANNUAL REPORT | 1999-03-10 |
| ANNUAL REPORT | 1998-02-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
