| Entity Name: | PRIMARY CARE PRACTITIONERS & ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 23 Jan 1998 (27 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P98000007532 |
| FEI/EIN Number | 65-0807784 |
| Address: | 102 NE 2ND AVE, HALLANDALE, FL 33009 |
| Mail Address: | 102 NE 2ND AVE, HALLANDALE, FL 33009 |
| ZIP code: | 33009 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790739100 | 2006-05-20 | 2009-03-24 | 102 NE 2ND AVE, HALLANDALE BEACH, FL, 330094212, US | 102 NE 2ND AVE, HALLANDALE BEACH, FL, 330094212, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 954-894-0522 |
| Fax | 9549641244 |
Authorized person
| Name | MR. IVORY JOE CHRISTEN |
| Role | OWNER |
| Phone | 9548940522 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 254320600 |
| State | FL |
| Issuer | TAXONOMIES |
| Number | 207Q00000X |
| State | FL |
| Issuer | BC/BS |
| Number | Y21701 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHRISTEN, IVORY J | Agent | 10641 SW 37TH PLACE, DAVIE, FL 33328 |
| Name | Role | Address |
|---|---|---|
| CHRISTEN, IVORY J | PCOD | 10641 SW 37TH PLACE, DAVIE, FL 33328 |
| Name | Role | Address |
|---|---|---|
| CHRISTEN, IGDALIS | Vice President | 10641 SW 37TH PLACE, DAVIE, FL 33328 |
| Name | Role | Address |
|---|---|---|
| CHRISTEN, IGDALIS | Director | 10641 SW 37TH PLACE, DAVIE, FL 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CANCEL ADM DISS/REV | 2009-03-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-06-25 | 10641 SW 37TH PLACE, DAVIE, FL 33328 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-06-25 | CHRISTEN, IVORY J | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-04-18 | 102 NE 2ND AVE, HALLANDALE, FL 33009 | No data |
| CHANGE OF MAILING ADDRESS | 2005-04-18 | 102 NE 2ND AVE, HALLANDALE, FL 33009 | No data |
| REINSTATEMENT | 2004-03-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| AMENDMENT | 1999-05-27 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J10000290558 | TERMINATED | 1000000150704 | BROWARD | 2009-12-11 | 2030-02-16 | $ 1,859.34 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-05-03 |
| REINSTATEMENT | 2009-03-11 |
| ANNUAL REPORT | 2007-06-25 |
| ANNUAL REPORT | 2006-04-27 |
| ANNUAL REPORT | 2005-04-18 |
| REINSTATEMENT | 2004-03-15 |
| ANNUAL REPORT | 2002-12-20 |
| ANNUAL REPORT | 2002-02-25 |
| DEBIT MEMO DISSOLUTI | 2002-02-15 |
| ANNUAL REPORT | 2001-10-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
