DR. KENNETH BLAZE, PA
Medical Practice in Hollywood, FL

License number

Florida 3106

Issued Date

Aug 8, 2003

Effective Date

Aug 8, 2003

Expiration Date

Aug 8, 2005

Organization information

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DR. KENNETH BLAZE P.A. AND ASSOCIATES

Hollywood, FL - Fort Lauderdale, FL

Status:

Inactive

Inactive reason:

VOLUNTARY DISSOLUTION

Registration:

Jun 10, 2003

Inactive since:

Dec 30, 2014

Addresses:

3 SW 129 Ave SUITE 101, Hollywood, FL 33027 (Physical)
7800 W Oakland Park Blvd E 214, Fort Lauderdale, FL 33351 (Mailing)
7800 W Oakland Park Blvd, Fort Lauderdale, FL 33351
1 SW 120 Ave, Hollywood, FL 33027

State ID:

P03000064128

Business type:

Florida Profit Corporation

Vice Presidents:

Gonzalez, Manuel D, Dr, 7800 W Oakland Park Blvd, Fort Lauderdale, FL 33351 (Physical),Gonzalez, Ada, Dr, 7800 W Oakland Park Blvd, Fort Lauderdale, FL 33351 (Physical),Jeffrey P Dudley, 7800 W Oakland Park Blvd, Fort Lauderdale, FL 33351 (Physical),...

Agent:

Vengel, Scott M, Cpa,7320 Griffin Rd SUITE 223, Fort Lauderdale, FL 33314 (Physical)

EIN:

20-0046242