| Entity Name: | SIGFREDO ACOSTA-PEREZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Nov 2000 (24 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P00000105274 |
| FEI/EIN Number | 593680703 |
| Address: | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| Mail Address: | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| ZIP code: | 34222 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619190402 | 2007-04-10 | 2020-08-22 | 595 N COURTENAY PKWY, SUITE 204, MERRITT ISLAND, FL, 329534851, US | 595 N COURTENAY PKWY, SUITE 204, MERRITT ISLAND, FL, 329534851, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-452-3920 |
| Fax | 3214591258 |
Authorized person
| Name | DR. SIGFREDO ACOSTA-PEREZ |
| Role | PRESIDENT |
| Phone | 3214523920 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME 64632 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CORESOURCE ID # |
| Number | 0502937 |
| Issuer | BC-BS ID # |
| Number | 23749 |
| Issuer | CIGNA ID # |
| Number | 81083 |
| Issuer | AETNA ID # |
| Number | 4348228 |
| Issuer | HUMANA ACCOUNT # |
| Number | EM002 88779 |
| Name | Role | Address |
|---|---|---|
| ACOSTA-PEREZ SIGFREDO M | Agent | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| Name | Role | Address |
|---|---|---|
| ACOSTA-PEREZ SIGFREDO M | President | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| Name | Role | Address |
|---|---|---|
| ACOSTA-PEREZ SIGFREDO M | Director | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| RODRIGO-CABRERA CARMEN A | Director | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| Name | Role | Address |
|---|---|---|
| RODRIGO-CABRERA CARMEN A | Vice President | 5435 74TH PLACE EAST, ELLENTON, FL, 34222 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08071900261 | MERRITT ISLAND PEDIATRICS | EXPIRED | 2008-03-11 | 2013-12-31 | No data | 595 N COURTENAY PARKWAY, SUITE 204, MERRITT ISLAND, FL, 32953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-09-16 | 5435 74TH PLACE EAST, ELLENTON, FL 34222 | No data |
| CHANGE OF MAILING ADDRESS | 2010-09-16 | 5435 74TH PLACE EAST, ELLENTON, FL 34222 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-09-16 | ACOSTA-PEREZ, SIGFREDO MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-09-16 | 5435 74TH PLACE EAST, ELLENTON, FL 34222 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-09-16 |
| ANNUAL REPORT | 2010-04-23 |
| ANNUAL REPORT | 2009-03-30 |
| ANNUAL REPORT | 2008-03-11 |
| ANNUAL REPORT | 2007-05-01 |
| ANNUAL REPORT | 2006-02-02 |
| ANNUAL REPORT | 2005-03-07 |
| ANNUAL REPORT | 2004-03-01 |
| ANNUAL REPORT | 2003-04-02 |
| ANNUAL REPORT | 2002-04-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
