| Entity Name: | WILLIAM S. NUTOVITS MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Mar 2003 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Apr 2011 (14 years ago) |
| Document Number: | P03000029669 |
| FEI/EIN Number | 753109054 |
| Address: | 5035 Via Delray, DELRAY BCH, FL, 33484, US |
| Mail Address: | 5035 Via Delray, DELRAY BCH, FL, 33484, US |
| ZIP code: | 33484 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578832945 | 2011-12-14 | 2021-06-04 | 5035 VIA DELRAY STE 2, DELRAY BEACH, FL, 334841315, US | 5035 VIA DELRAY STE 2, DELRAY BEACH, FL, 334841315, US | |||||||||||||||||||||||||
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| Phone | +1 561-330-0111 |
| Fax | 5613307635 |
Authorized person
| Name | WILLIAM S NUTOVITS |
| Role | OWNER |
| Phone | 5613300111 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | ME69099 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 378813000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SPERDUTO GUY D | Agent | 8963 Stirling Road, Cooper City, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| NUTOVITS WILLIAM S | Director | 5035 Via Delray, DELRAY BCH, FL, 33484 |
| Name | Role | Address |
|---|---|---|
| NUTOVITS WILLIAM S | President | 5035 Via Delray, DELRAY BCH, FL, 33484 |
| Name | Role | Address |
|---|---|---|
| NUTOVITS WILLIAM S | Secretary | 5035 Via Delray, DELRAY BCH, FL, 33484 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-19 | 5035 Via Delray, DELRAY BCH, FL 33484 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-19 | 5035 Via Delray, DELRAY BCH, FL 33484 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 8963 Stirling Road, Suite 101, Cooper City, FL 33328 | No data |
| REINSTATEMENT | 2011-04-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-02-15 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-02-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4072097105 | 2020-04-12 | 0455 | PPP | 5035 Via Delray Boulevard, Delray Beach, FL, 33484 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Feb 2025
Sources: Florida Department of State
