| Entity Name: | PRINCETON MEDICAL GROUP OF BOCA RATON, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Feb 2021 (4 years ago) |
| Document Number: | L21000060347 |
| FEI/EIN Number | 86-2065083 |
| Address: | 2240 WOOLBRIGHT ROAD, SUITE 317, BOYNTON BEACH, FL, 33427, UN |
| Mail Address: | 2240 WOOLBRIGHT ROADSUITE 317, SUITE 317, BOYNTON BEACH, FL, 33426, UN |
| ZIP code: | 33427 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407432743 | 2021-03-18 | 2021-03-18 | 2240 W WOOLBRIGHT RD STE 317, BOYNTON BEACH, FL, 334266364, US | 9970 CENTRAL PARK BLVD N STE 404, BOCA RATON, FL, 334282236, US | |||||||||||||||
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| Phone | +1 561-200-0047 |
| Phone | +1 561-483-1125 |
Authorized person
| Name | FRANCISCO PEREZ |
| Role | OWNER |
| Phone | 5614831125 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LUCIBELLA RICHARD | Agent | 2240 WOOLBRIGHT ROAD, BOYNTON BEACH, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| Lucibella Richard J | Mr | 2240 Woolbright Rd, Boynton Beach, FL, 33426 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000027187 | PRINCETON MEDICAL GROUP | ACTIVE | 2021-02-25 | 2026-12-31 | No data | 2240 WOOLBRIGHT RD STE 317, BOYNTON BEACH, FL, 33426 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-31 |
| Florida Limited Liability | 2021-02-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
