| Entity Name: | SUSSMAN OBGYN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Aug 2016 (8 years ago) |
| Document Number: | L16000158137 |
| FEI/EIN Number | 54-2129332 |
| Mail Address: | 3225 AVIATION AVENUE, SUITE 700, MIAMI, FL 33133 |
| Address: | 1301 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL 33435 |
| ZIP code: | 33435 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588287437 | 2020-05-27 | 2020-05-27 | 2800 S SEACREST BLVD STE 220, BOYNTON BEACH, FL, 334357965, US | 2800 S SEACREST BLVD STE 220, BOYNTON BEACH, FL, 334357965, US | |||||||||||||||||||||
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| Phone | +1 561-742-3929 |
| Fax | 5617423931 |
Authorized person
| Name | ROBERT BRIAN SUSSMAN |
| Role | PRESIDENT/OWNER |
| Phone | 5617423929 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1285656918 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YELEN, MITCH | Agent | 3444 Main HWY., 2nd Floor, Miami, FL 33133 |
| Name | Role |
|---|---|
| VITALMD GROUP HOLDING, LLC | Authorized Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-02 | 3444 Main HWY., 2nd Floor, Miami, FL 33133 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-09-15 | 1301 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL 33435 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-24 |
| ANNUAL REPORT | 2022-01-08 |
| ANNUAL REPORT | 2021-03-08 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-02-28 |
| ANNUAL REPORT | 2017-04-27 |
| Florida Limited Liability | 2016-08-23 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
