PRIMARY CARE PRACTITIONERS OF SOUTH FLORIDA, INC.
Osteopathic Medicine at 2 Ave, Golden Isles, FL

License number
Florida ME0049240
Category
Osteopathic Medicine
Type
General Practice
License number
Florida OS0007497
Category
Osteopathic Medicine
Type
General Practice
License number
Florida OS0001922
Category
Osteopathic Medicine
Type
General Practice
License number
Florida ARNP1714142
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: IVORY J CHRISTEN ARNP
Title: VICE PRESIDENT
Phone: (954) 894-0522
Address
Address
102 NE 2Nd Ave, Golden Isles, FL 33009
National Provider ID: 1356679989
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PRIMARY CARE PRACTITIONERS OF SOUTH FLORIDA, INC

West Palm Beach, FL  -  Golden Isles, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Aug 27, 2009
Inactive since:
Sep 24, 2010
Addresses:
200 S Rosemary Ave, West Palm Beach, FL 33401 (Physical)
201 E Hallandale Bch Blvd #B, Hallandale, FL 33009 (Mailing)
PO Box 4110, Golden Isles, FL 33008
State ID:
P09000072000
Business type:
Florida Profit Corporation
President, Vice Presidents:
Willie S Christen President, inactive, PO Box 4110, Hallandale, FL 33009 (Physical),Ivory J Christen President, Vice President, inactive, PO Box 4110, Hallandale, FL 33009 (Physical)
Agent:
Yolanda Goldwire,208 NE 1 Ave, Hallandale, FL 33009 (Physical)
EIN:
NO-NE

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