| Entity Name: | GERARDO QUINONEZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Dec 2001 (23 years ago) |
| Document Number: | P01000114530 |
| FEI/EIN Number | 651157155 |
| Address: | 8190 JOG ROAD, SUITE 100, BOYNTON BEACH, FL, 33472 |
| Mail Address: | 8190 JOG ROAD, SUITE 100, BOYNTON BEACH, FL, 33472 |
| ZIP code: | 33472 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073533683 | 2006-07-20 | 2008-09-29 | 1700 W WOOLBRIGHT RD, SUITE #5, BOYNTON BEACH, FL, 334266346, US | 1700 W WOOLBRIGHT RD, SUITE #5, BOYNTON BEACH, FL, 334266346, US | |||||||||||||||||||||||||
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| Phone | +1 561-369-2144 |
| Fax | 5613692117 |
Authorized person
| Name | DR. GERARDO QUINONEZ |
| Role | MEDICAL DIRECTOR |
| Phone | 5613692144 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME80428 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 264184400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| QUINONEZ GERARDO M | Agent | 8190 JOG ROAD, BOYNTON BEACH, FL, 33472 |
| Name | Role | Address |
|---|---|---|
| QUINONEZ GERARDO | Director | 8190 JOG ROAD SUITE 100, BOCA RATON, FL, 33472 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000070095 | INTERNAL MEDICINE OF BOYNTON BEACH | ACTIVE | 2017-06-27 | 2027-12-31 | No data | 8190 JOG ROAD, SUITE 100, BOYNTON BEACH, FL, 33472 |
| G10000058790 | INTERNAL MEDICINE OF BOYNTON BEACH | EXPIRED | 2010-06-23 | 2015-12-31 | No data | 8190 JOG ROAD #100, BOYNTON BEACH, FL, 33472 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-30 | 8190 JOG ROAD, SUITE 100, BOYNTON BEACH, FL 33472 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-26 | 8190 JOG ROAD, SUITE 100, BOYNTON BEACH, FL 33472 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-26 | 8190 JOG ROAD, SUITE 100, BOYNTON BEACH, FL 33472 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
