| Entity Name: | IBIZA NEVARES, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Mar 1998 (27 years ago) |
| Document Number: | P98000029735 |
| FEI/EIN Number | 650834638 |
| Mail Address: | 1440 CORAL RIDGE DR, CORAL SPRINGS, FL, 33071, US |
| Address: | 11907 GLENMORE DRIVE, CORAL SPRINGS, FL, 33071, US |
| ZIP code: | 33071 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952608549 | 2011-02-17 | 2011-03-21 | 7100 W COMMERCIAL BLVD, SUITE 105, LAUDERHILL, FL, 333192155, US | 7100 W COMMERCIAL BLVD, SUITE 105, LAUDERHILL, FL, 333192155, US | |||||||||||||||||||
|
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| Phone | +1 954-578-2292 |
| Fax | 9545782330 |
Authorized person
| Name | DR. IBIZA NEVARES |
| Role | PRESIDENT |
| Phone | 9545782292 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | 71574 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Nevares Ibiza Dr. | Agent | 1440 CORAL RIDGE DR, CORAL SPRINGS, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| NEVARES IBIZA | President | 1440 CORAL RIDGE DRIVE, CORAL SPRINGS, FL, 33071 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
