| Entity Name: | GARY H. DIBLASIO, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Jun 2001 (24 years ago) |
| Document Number: | P01000057724 |
| FEI/EIN Number | 651116395 |
| Address: | 701 NORTHLAKE BLVD., STE. 208, NORTH PALM BEACH, FL, 33408 |
| Mail Address: | 701 NORTHLAKE BLVD., STE. 208, NORTH PALM BEACH, FL, 33408 |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538473053 | 2010-07-27 | 2010-07-28 | 5500 VILLAGE BLVD, STE 101, WEST PALM BEACH, FL, 334071961, US | 5500 VILLAGE BLVD, STE 101, WEST PALM BEACH, FL, 334071961, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 561-684-6565 |
| Fax | 5616843467 |
Authorized person
| Name | GARY HENRY DIBLASIO |
| Role | PRESIDENT/OWNER |
| Phone | 5616846565 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | ME74052 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DIBLASIO MD GARY H | Agent | 701 NORTHLAKE BLVD., NORTH PALM BEACH, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| DIBLASIO GARY HMD | Director | 102 DEL SOL CIRCLE, TEQUESTA, FL, 33469 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000015067 | ADVANCED MEDICAL REHABILITATION GROUP | ACTIVE | 2014-02-12 | 2029-12-31 | No data | 701 NORTHLAKE BLVD., STE, 208, NORTH PALM BEACH, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-07 | 701 NORTHLAKE BLVD., STE. 208, NORTH PALM BEACH, FL 33408 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-01 | DIBLASIO MD, GARY H | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-27 | 701 NORTHLAKE BLVD., STE. 208, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-27 | 701 NORTHLAKE BLVD., STE. 208, NORTH PALM BEACH, FL 33408 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-01 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-03-01 |
| ANNUAL REPORT | 2020-02-12 |
| ANNUAL REPORT | 2019-02-01 |
| ANNUAL REPORT | 2018-01-29 |
| ANNUAL REPORT | 2017-02-03 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-01-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
