| Entity Name: | ALAN BALSAM, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Apr 2001 (24 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 19 Oct 2018 (6 years ago) |
| Document Number: | P01000037579 |
| FEI/EIN Number | 651101872 |
| Address: | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Mail Address: | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| ZIP code: | 33446 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508026485 | 2008-06-13 | 2013-03-29 | 3275 W HILLSBORO BLVD, SUITE 210, DEERFIELD BEACH, FL, 334429536, US | 3275 W HILLSBORO BLVD, SUITE 210, DEERFIELD BEACH, FL, 334429536, US | |||||||||||||||||||
|
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| Phone | +1 954-426-2898 |
| Fax | 9544282769 |
Authorized person
| Name | DR. ALAN BALSAM |
| Role | PRESIDENT |
| Phone | 5613503100 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME22243 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BALSAM ALAN | Agent | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Name | Role | Address |
|---|---|---|
| BALSAM ALAN | President | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Name | Role | Address |
|---|---|---|
| BALSAM ALAN | Vice President | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Name | Role | Address |
|---|---|---|
| BALSAM ALAN | Treasurer | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Name | Role | Address |
|---|---|---|
| BALSAM ALAN | Secretary | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Name | Role | Address |
|---|---|---|
| BALSAM ALAN | Director | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL, 33446 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2018-10-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-10-19 | BALSAM, ALAN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-03-31 | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL 33446 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-04-24 | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL 33446 | No data |
| CHANGE OF MAILING ADDRESS | 2003-04-24 | 16137 BRISTOL POINTE DRIVE, DELRAY BEACH, FL 33446 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-02-06 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-03-06 |
| REINSTATEMENT | 2018-10-19 |
| ANNUAL REPORT | 2017-04-22 |
| ANNUAL REPORT | 2016-04-06 |
| ANNUAL REPORT | 2015-04-11 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
