| Entity Name: | SAMUEL RAND MEDICAL CLINIC, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Mar 1993 (32 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P93000017323 |
| FEI/EIN Number | 65-0400708 |
| Address: | 4480 SHERIDAN ST, EMERALD HILLS MEDICAL SQUARE, HOLLYWOOD, FL 33021 |
| Mail Address: | 4480 SHERIDAN ST, EMERALD HILLS MEDICAL SQUARE, HOLLYWOOD, FL 33021 |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134466360 | 2013-01-08 | 2013-01-08 | 4480 SHERIDAN ST, HOLLYWOOD, FL, 330213511, US | 4480 SHERIDAN ST, HOLLYWOOD, FL, 330213511, US | |||||||||||||||||||
|
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| Phone | +1 954-966-3300 |
| Fax | 9549663303 |
Authorized person
| Name | SAMUEL RAND |
| Role | OWNER/PHYSICIAN |
| Phone | 9549663300 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME24509 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Samuel Rand M.D. | Agent | 4480 SHERIDAN ST, EMERALD HILLS MEDICAL SQUARE, HOLLYWOOD, FL 33021 |
| Name | Role | Address |
|---|---|---|
| RAND, SAMUEL | Manager | 4480 SHERIDAN ST, EMERALD HILLS MEDICAL SQ HOLLYWOOD, FL 33021 |
| Name | Role | Address |
|---|---|---|
| RAND, SAMUEL | Director | 4480 SHERIDAN ST, EMERALD HILLS MEDICAL SQ HOLLYWOOD, FL 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2019-10-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-10-28 | Samuel Rand M.D. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-01-20 |
| REINSTATEMENT | 2019-10-28 |
| ANNUAL REPORT | 2018-02-18 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-03-05 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-03-31 |
| ANNUAL REPORT | 2013-01-29 |
| ANNUAL REPORT | 2012-01-08 |
| ANNUAL REPORT | 2011-01-09 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
