R GASTESI, MD PA
Ambulatory Health at Federal Hwy, Fort Lauderdale, FL

License number
Florida ME0017960
Category
Ambulatory Health
Type
Oncology
Owner
Name: DR. ROMAN GASTESI MD
Title: PRESIDENT
Phone: (954) 298-1273
Address
Address
2780 N Federal Hwy, Fort Lauderdale, FL 33306
National Provider ID: 1053750661
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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R. GASTESI, M.D., PA

816 NE 20 Ave, Fort Lauderdale, FL 33304

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Mar 14, 1996
Inactive since:
Sep 25, 2009
State ID:
P96000024353
Business type:
Florida Profit Corporation
President, Treasurer, Secretary, Director:
Roman A Gastesi President, Treasurer, Secretary, Director, inactive, 816 NE 20 Ave, Fort Lauderdale, FL 33304 (Physical)
Agent:
Roman Gastesi,816 NE 20 Ave, Fort Lauderdale, FL 33304 (Physical)
EIN:
650654995

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