ELISEO PEREZ, MD, PA
Medical Practice at 47 St, Fort Lauderdale, FL

License number
Florida ME 25845
Category
Medical Practice
Type
Occupational Medicine
Owner
Name: DR. ELISEO PEREZ M.D.
Title: PRESIDENT
Phone: (954) 493-5005
Address
Address
1960 NE 47Th St FLOOR 2ND, Fort Lauderdale, FL 33308
National Provider ID: 1780989525
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ELISEO PEREZ, M.D., PA

Fort Lauderdale, FL

Status:
Inactive
Doing business as:
ELISEO PEREZ MD PA
Inactive reason:
VOLUNTARY DISSOLUTION
Registration:
Jan 1, 1979
Inactive since:
Nov 8, 1999
Addresses:
1930 NE 47 #308, Fort Lauderdale, FL 33308 (Physical)
1960 NE 47 2, Fort Lauderdale, FL 33308 (Physical)
1930 NE 47 St, Fort Lauderdale, FL 33308
1960 NE 47 St, Fort Lauderdale, FL 33308
State ID:
598707
Business type:
Florida Profit Corporation
President, Director:
Eliseo Perez President, Director, inactive, 1930 NE 47 #308, Ft Lauderdale, FL (Physical)
1960 NE 47, Fort Lauderdale, FL 33308 (Physical)
Agent:
Perez, Eliseo,1930 NE 47 #308, Fort Lauderdale, FL 33308 (Physical)
EIN:
591870302

ELISEO PEREZ MD PA

Fort Lauderdale, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Dec 10, 2010
Inactive since:
Sep 26, 2014
Addresses:
1960 NE 47 2, Fort Lauderdale, FL 33308 (Physical)
1960 NE 47 St, Fort Lauderdale, FL 33308
State ID:
P10000100317
Business type:
Florida Profit Corporation
President:
Eliseo Md Perez President, inactive, 1960 NE 47, Fort Lauderdale, FL 33308 (Physical)
Agent:
Eliseo Perez,1960 NE 47, Fort Lauderdale, FL 33308 (Physical)
EIN:
900648743

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