| Entity Name: | BOCACARE 9TH AVENUE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 03 Aug 2009 (16 years ago) |
| Date of dissolution: | 28 Jun 2012 (13 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 28 Jun 2012 (13 years ago) |
| Document Number: | N09000007509 |
| FEI/EIN Number | 27-0660393 |
| Address: | 1599 NW 9TH AVE, BOCA RATON, FL 33486 |
| Mail Address: | 1599 NW 9TH AVE, BOCA RATON, FL 33486 |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235361635 | 2009-08-18 | 2009-08-18 | 1599 NW 9TH AVE, SUITE 203, BOCA RATON, FL, 334861310, US | 1599 NW 9TH AVE, SUITE 203, BOCA RATON, FL, 334861310, US | |||||||||||||||||||||||||
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| Phone | +1 561-392-6666 |
| Fax | 5613921583 |
Authorized person
| Name | MR. JERRY J FEDELE |
| Role | CEO |
| Phone | 5613926666 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME42340 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 73258 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EREMIA, ALEXANDER D | Agent | 800 MEADOWS ROAD, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| PYTHON, FRANTZ | President | 800 MEADOWS ROAD, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| FEDELE, JERRY J | Director | 800 MEADOWS ROAD, BOCA RATON, FL 33486 |
| JAVERSACK, DAWN | Director | 800 MEADOWS ROAD, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| EREMIA, ALEXANDER D | Secretary | 800 MEADOWS ROAD, BOCA RATON, FL 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2012-06-28 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS N09000000803. MERGER NUMBER 700000123777 |
| REGISTERED AGENT NAME CHANGED | 2012-04-19 | EREMIA, ALEXANDER D | No data |
| AMENDMENT | 2010-01-19 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-11-12 | 1599 NW 9TH AVE, BOCA RATON, FL 33486 | No data |
| CHANGE OF MAILING ADDRESS | 2009-11-12 | 1599 NW 9TH AVE, BOCA RATON, FL 33486 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-19 |
| ANNUAL REPORT | 2011-03-15 |
| ANNUAL REPORT | 2010-04-15 |
| Amendment | 2010-01-19 |
| Domestic Non-Profit | 2009-08-03 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
