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  5. ANDRES PATRON, D.O., P.A.

ANDRES PATRON, D.O., P.A.

Company Details

Entity Name: ANDRES PATRON, D.O., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 21 Mar 2003 (22 years ago)
Document Number: P03000032978
FEI/EIN Number 050560236
Address: 10796 PINES BLVD., SUITE 205, PEMBROKE PINES, FL, 33026
Mail Address: 10796 PINES BLVD., SUITE 205, PEMBROKE PINES, FL, 33026
ZIP code: 33026
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1346336211 2006-10-05 2020-08-22 10796 PINES BLVD, SUITE #205, PEMBROKE PINES, FL, 330263919, US 10796 PINES BLVD, SUITE #205, PEMBROKE PINES, FL, 330263919, US

Contacts
Phone +1 954-885-5555
Fax 9548855333

Authorized person
Name DR. ANDRES PATRON
Role PHYSICIAN/CEO
Phone 9548855555

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number OS6273
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2023 050560236 2024-03-15 ANDRES PATRON, D.O., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2024-03-15
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2022 050560236 2023-06-28 ANDRES PATRON, D.O., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2023-06-28
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2021 050560236 2022-04-07 ANDRES PATRON, D.O., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2022-04-07
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2020 050560236 2021-05-03 ANDRES PATRON, D.O., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2021-05-03
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2019 050560236 2020-05-08 ANDRES PATRON, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2020-05-08
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2018 050560236 2019-03-28 ANDRES PATRON, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2019-03-25
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-25
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2017 050560236 2018-03-19 ANDRES PATRON, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2018-03-19
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2016 050560236 2017-06-01 ANDRES PATRON, D.O., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2017-06-01
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2015 050560236 2016-04-18 ANDRES PATRON, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD STE 205, PEMBROKE PINES, FL, 330263919

Signature of
Role Plan administrator
Date 2016-04-18
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature
ANDRES PATRON, D.O., P.A. RETIREMENT PLAN AND TRUST 2014 050560236 2015-05-21 ANDRES PATRON, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9548855555
Plan sponsor’s address 10796 PINES BLVD., SUITE 205, PEMBROKE PINES, FL, 33026

Signature of
Role Plan administrator
Date 2015-05-21
Name of individual signing ANDRES PATRON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PATRON MARILYN Agent 7011 MELALEUCA RD, SOUTHWEST RANCHES, FL, 33330

Director

Name Role Address
PATRON ANDRES Director 10796 PINES BLVD., SUITE 205, PEMBROKE PINES, FL, 33026

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2011-01-06 7011 MELALEUCA RD, SOUTHWEST RANCHES, FL 33330 No data
CHANGE OF PRINCIPAL ADDRESS 2010-01-06 10796 PINES BLVD., SUITE 205, PEMBROKE PINES, FL 33026 No data
CHANGE OF MAILING ADDRESS 2010-01-06 10796 PINES BLVD., SUITE 205, PEMBROKE PINES, FL 33026 No data
REGISTERED AGENT NAME CHANGED 2008-01-22 PATRON, MARILYN No data

Documents

Name Date
ANNUAL REPORT 2024-03-11
ANNUAL REPORT 2023-03-02
ANNUAL REPORT 2022-02-18
ANNUAL REPORT 2021-01-12
ANNUAL REPORT 2020-02-24
ANNUAL REPORT 2019-02-28
ANNUAL REPORT 2018-02-07
ANNUAL REPORT 2017-02-14
ANNUAL REPORT 2016-01-13
ANNUAL REPORT 2015-01-21

Related by officers

PATRON ANDRES

AMCAP VENTURES LLC PATRON VENTURES, LLC

PATRON MARILYN

AMCAP VENTURES LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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