| Entity Name: | FAMILY PHYSICIAN SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Jan 2002 (23 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Jun 2011 (14 years ago) |
| Document Number: | P02000011250 |
| FEI/EIN Number | 752989139 |
| Address: | 10278 BUENA VENTURA DR, BOCA RATON, FL, 33498, US |
| Mail Address: | 10278 BUENA VENTURA DR, BOCA RATON, FL, 33498, US |
| ZIP code: | 33498 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043402589 | 2007-08-17 | 2013-06-26 | 10278 BUENA VENTURA DR, BOCA RATON, FL, 334986766, US | 801 MEADOWS RD STE 111B, BOCA RATON, FL, 334862346, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 561-368-7055 |
| Fax | 5613686599 |
Authorized person
| Name | DR. DWIGHT G AYALA |
| Role | FAMILY PHYSICIAN |
| Phone | 5613687055 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME83667 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AYALA DWIGHT G | Agent | 10278 BUENA VENTURA DR, BOCA RATON, FL, 33498 |
| Name | Role | Address |
|---|---|---|
| AYALA DWIGHT M | President | 10278 BUENA VENTURA DR, BOCA RATON, FL, 33498 |
| Name | Role | Address |
|---|---|---|
| AYALA MARIANELA | Vice President | 10278 BUENA VENTURA DR, BOCA RATON, FL, 33498 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-05-01 | 10278 BUENA VENTURA DR, BOCA RATON, FL 33498 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-05-01 | 10278 BUENA VENTURA DR, BOCA RATON, FL 33498 | No data |
| CHANGE OF MAILING ADDRESS | 2014-05-01 | 10278 BUENA VENTURA DR, BOCA RATON, FL 33498 | No data |
| REINSTATEMENT | 2011-06-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2008-05-05 | AYALA, DWIGHT GM.D. | No data |
| CANCEL ADM DISS/REV | 2007-09-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CANCEL ADM DISS/REV | 2006-04-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-03-10 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
