| Entity Name: | MIRTA BATISTA-TATUM INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 08 May 1992 (33 years ago) |
| Document Number: | V35812 |
| FEI/EIN Number | 650333102 |
| Address: | 4767 SW 195TH TERRACE, MIRAMAR, FL, 33029, US |
| Mail Address: | 4767 SW 195TH TERRACE, MIRAMAR, FL, 33029, US |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336573039 | 2013-08-29 | 2013-08-29 | 4767 SW 195TH TER, MIRAMAR, FL, 330296209, US | 4767 SW 195TH TER, MIRAMAR, FL, 330296209, US | |||||||||||||||||
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| Phone | +1 754-246-0625 |
Authorized person
| Name | MS. MIRTA BATISTA TATUM |
| Role | PHYSICAL THERAPIST |
| Phone | 7542460625 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | 0004025 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BATISTA-TATUM, MIRTA | Agent | 4767 SW 195TH TERRACE, MIRAMAR, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| BATISTA-TATUM MIRTA | President | 4767 SW 195TH TERRACE, MIRAMAR, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REINSTATEMENT | 2011-10-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CANCEL ADM DISS/REV | 2004-05-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| REINSTATEMENT | 1995-04-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1994-08-26 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
