| Entity Name: | MICHAEL V. RIESBERG MD OTOLARYNGOLOGY AND PERFORMING ARTS MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Sep 2002 (22 years ago) |
| Document Number: | P02000104864 |
| FEI/EIN Number | 542076559 |
| Address: | 4900 NORTH DAVIS HWY, PENSACOLA, FL, 32503 |
| Mail Address: | 4900 NORTH DAVIS HWY, PENSACOLA, FL, 32503 |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497990972 | 2008-12-11 | 2009-01-22 | PO BOX 1759, DEPARTMENT 952, HOUSTON, TX, 772511759, US | 4900 N. DAVIS HIGHWAY, PENSACOLA, FL, 325032344, US | |||||||||||||||||||||||||||
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| Phone | +1 713-554-5304 |
| Fax | 7135545324 |
| Phone | +1 850-476-0700 |
| Fax | 8504764300 |
Authorized person
| Name | MICHAEL V RIESBER |
| Role | PRESIDENT |
| Phone | 8504760700 |
Taxonomy
| Taxonomy Code | 207Y00000X - Otolaryngology Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 44913 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RIESBERG MICHAEL V | Agent | 4900 N Davis Hwy, Pensacola, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| RIESBERG MICHAEL V | Director | 4900 NORTH DAVIS HWY, PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-18 | 4900 N Davis Hwy, Pensacola, FL 32503 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-04 | 4900 NORTH DAVIS HWY, PENSACOLA, FL 32503 | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-04 | 4900 NORTH DAVIS HWY, PENSACOLA, FL 32503 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-02-18 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-04-13 |
| ANNUAL REPORT | 2015-03-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
