| Entity Name: | SANTA ROSA PEDIATRICS OF FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 May 2005 (20 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 23 Dec 2005 (19 years ago) |
| Document Number: | P05000073294 |
| FEI/EIN Number | 202869580 |
| Address: | 5962 BERRY HILL RD, MILTON, FL, 32570 |
| Mail Address: | 5962 BERRY HILL RD, MILTON, FL, 32570 |
| ZIP code: | 32570 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922095512 | 2005-09-29 | 2020-08-22 | 5962 BERRYHILL RD, MILTON, FL, 325704009, US | 5962 BERRYHILL RD, MILTON, FL, 325704009, US | |||||||||||||||||||||||
|
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| Phone | +1 850-983-3700 |
| Fax | 8509830970 |
Authorized person
| Name | DR. LUIS A GHIGLINO |
| Role | OWNER |
| Phone | 8509833700 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME90770 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DR. LUIS A GHIGLINO |
| Number | IND NPI |
| Name | Role | Address |
|---|---|---|
| GHIGLINO LUIS A | Agent | 5962 BERRY HILL RD, MILTON, FL, 32570 |
| Name | Role | Address |
|---|---|---|
| GHIGLINO LUIS A | Director | 5962 BERRY HILL RD, MILTON, FL, 32570 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2006-03-26 | GHIGLINO, LUIS AMD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-03-26 | 5962 BERRY HILL RD, MILTON, FL 32570 | No data |
| AMENDMENT AND NAME CHANGE | 2005-12-23 | SANTA ROSA PEDIATRICS OF FLORIDA, P.A. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-12-23 | 5962 BERRY HILL RD, MILTON, FL 32570 | No data |
| CHANGE OF MAILING ADDRESS | 2005-12-23 | 5962 BERRY HILL RD, MILTON, FL 32570 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-02-06 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-05-27 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-01-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
