| Entity Name: | AGUSTIN A. BURGOS, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Apr 2004 (21 years ago) |
| Document Number: | P04000063378 |
| FEI/EIN Number | 201035321 |
| Address: | 1499 W Palmetto Park Rd, Boca Raton, FL, 33486, US |
| Mail Address: | 1113 Waterside Circle, Weston, FL, 33327, US |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902049760 | 2009-04-09 | 2009-04-09 | 201 NW 82ND AVE, SUITE 405, PLANTATION, FL, 333247808, US | 201 NW 82ND AVE, SUITE 405, PLANTATION, FL, 333247808, US | |||||||||||||||||||
|
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| Phone | +1 954-472-1354 |
| Fax | 9543703420 |
Authorized person
| Name | AGUSTIN A BURGOS |
| Role | OWNER |
| Phone | 9544721354 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME78600 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BURGOS AGUSTIN | Agent | 1113 Waterside Circle, Weston, FL, 33327 |
| Name | Role | Address |
|---|---|---|
| BURGOS AGUSTIN Dr. | President | 1113 Waterside Circle, Weston, FL, 33327 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-23 | 1499 W Palmetto Park Rd, 120, Boca Raton, FL 33486 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-23 | 1499 W Palmetto Park Rd, 120, Boca Raton, FL 33486 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-23 | BURGOS, AGUSTIN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-23 | 1113 Waterside Circle, Weston, FL 33327 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-08 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-31 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-03-22 |
| ANNUAL REPORT | 2017-01-21 |
| ANNUAL REPORT | 2016-01-19 |
| ANNUAL REPORT | 2015-02-04 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
