| Entity Name: | BOZENA B. SABALA, DO, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 May 2004 (21 years ago) |
| Document Number: | P04000071557 |
| FEI/EIN Number | 201072050 |
| Address: | 525 S. Hercules Ave., CLEARWATER, FL, 33764, US |
| Mail Address: | 525 S. Hercules Ave., CLEARWATER, FL, 33764, US |
| ZIP code: | 33764 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164605408 | 2007-12-10 | 2008-10-10 | 2014 DREW ST, STE 1, CLEARWATER, FL, 337653100, US | 2014 DREW ST, STE 1, CLEARWATER, FL, 337653100, US | |||||||||||||||||||
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| Phone | +1 727-443-3832 |
| Fax | 7274437903 |
Authorized person
| Name | DR. BOZENA BARBARA SABALA |
| Role | PRESIDENT |
| Phone | 7274433832 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS8316 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SABALA BOZENA B | Agent | 525 S. Hercules Ave., CLEARWATER, FL, 33764 |
| Name | Role | Address |
|---|---|---|
| SABALA BOZENA B | President | 525 S. Hercules Ave., CLEARWATER, FL, 33764 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-25 | 525 S. Hercules Ave., Unit 101, CLEARWATER, FL 33764 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-25 | 525 S. Hercules Ave., Unit 101, CLEARWATER, FL 33764 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-25 | 525 S. Hercules Ave., Unit 101, CLEARWATER, FL 33764 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-02-09 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
