| Entity Name: | NORBERTO VAZQUEZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Dec 2002 (22 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P02000133464 |
| FEI/EIN Number | 431983620 |
| Address: | 1910 FLOWER DRIVE, PALM BEACH GARDENS, FL, 33410, US |
| Mail Address: | 1910 FLOWER DRIVE, PALM BEACH GARDENS, FL, 33410, US |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407926694 | 2006-11-08 | 2020-08-22 | 1411 N FLAGLER DR, SUITE 4600, WEST PALM BEACH, FL, 334013404, US | 1411 N FLAGLER DR, SUITE 4600, WEST PALM BEACH, FL, 334013404, US | |||||||||||||||||||||
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| Phone | +1 561-655-0356 |
| Fax | 5616590492 |
Authorized person
| Name | NORBERTO VAZQUEZ |
| Role | PHYSCIAN |
| Phone | 5616550356 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE RAILROAD |
| Number | DB4587 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ NORBERTO M.D. | Agent | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ NORBERTO M.D. | President | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ NORBERTO M.D. | Vice President | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ NORBERTO M.D. | Secretary | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ NORBERTO M.D. | Treasurer | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| VAZQUEZ NORBERTO M.D. | Director | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-05-22 | 1910 FLOWER DRIVE, PALM BEACH GARDENS, FL 33410 | No data |
| CHANGE OF MAILING ADDRESS | 2014-05-22 | 1910 FLOWER DRIVE, PALM BEACH GARDENS, FL 33410 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-18 | 1411 N. FLAGLER DR., STE. 4600, WEST PALM BEACH, FL 33401 | No data |
| CANCEL ADM DISS/REV | 2005-11-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| REINSTATEMENT | 2003-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-05-03 |
| ANNUAL REPORT | 2009-04-27 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-02-14 |
| ANNUAL REPORT | 2006-01-18 |
| REINSTATEMENT | 2005-11-03 |
| ANNUAL REPORT | 2004-04-05 |
| REINSTATEMENT | 2003-10-13 |
| Domestic Profit | 2002-12-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
