| Entity Name: | DR. NEAL F. KROUSE, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 18 Apr 1997 (28 years ago) |
| Date of dissolution: | 14 Sep 2007 (17 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 14 Sep 2007 (17 years ago) |
| Document Number: | P97000034997 |
| FEI/EIN Number | 650745212 |
| Address: | 458 W. HILLSBORO BLVD., DEERFIELD BEACH, FL, 33441 |
| Mail Address: | 458 W. HILLSBORO BLVD., DEERFIELD BEACH, FL, 33441 |
| ZIP code: | 33441 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003119173 | 2010-12-13 | 2010-12-13 | 2345 W HILLSBORO BLVD, SUITE 103, DEERFIELD BEACH, FL, 334421110, US | 2345 W HILLSBORO BLVD, SUITE 103, DEERFIELD BEACH, FL, 334421110, US | |||||||||||||||||||||
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| Phone | +1 954-418-9445 |
| Fax | 9544189445 |
Authorized person
| Name | DR. NEAL FARRELL KROUSE |
| Role | PHYSICIAN |
| Phone | 9544189445 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002736700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KROUSE NEAL F | Agent | 458 W. HILLSBORO BLVD., DEERFIELD BEACH, FL, 33441 |
| Name | Role | Address |
|---|---|---|
| KROUSE NEAL F | Director | 458 W. HILLSBORO BLVD., DEERFIELD BEACH, FL, 33441 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| REINSTATEMENT | 2002-09-30 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2002-09-30 | KROUSE, NEAL F | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-09-30 | 458 W. HILLSBORO BLVD., DEERFIELD BEACH, FL 33441 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-02-02 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J10000270840 | ACTIVE | 1000000147240 | BROWARD | 2009-10-30 | 2030-02-16 | $ 1,893.93 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096 |
| J09000772896 | LAPSED | 202008SC015982XXXXSB | CNTY CRT 15TH JUD CIR PALM BCH | 2009-02-11 | 2014-03-05 | $6,326.44 | SHAPIRO BLASI, WASSERMAN & GORA, P.A., 7777 GLADES ROAD, SUITE 400, BOCA RATON, FL 33434 |
| J08900001236 | LAPSED | 06 CA 001581 AO | PALM BEACH CTY CRT | 2007-11-21 | 2013-01-25 | $10287.14 | MICHAUD, MITTLELMARK & ANTONACCI, P.A., 621 NW 53RD STREET, SUITE 420, BOCA RATON, FL 33487 |
| J08900001365 | LAPSED | 06 CA 001581 AO | PALM BEACH CTY CRT | 2007-06-18 | 2013-01-28 | $18472.73 | MICHAUD, MITTELMARK & ANTONACCI, P.A., 621 NW 53RD STREET, SUITE 420, BOCA RATON, FL 33487 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2006-05-04 |
| ANNUAL REPORT | 2005-08-10 |
| ANNUAL REPORT | 2004-04-28 |
| ANNUAL REPORT | 2003-09-10 |
| REINSTATEMENT | 2002-09-30 |
| DEBIT MEMO DISSOLUTI | 1999-02-02 |
| Domestic Profit Articles | 1997-04-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
