| Entity Name: | ARKADIY V. PURYGIN, M.D., D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Jul 2005 (20 years ago) |
| Document Number: | P05000094151 |
| FEI/EIN Number | 203187674 |
| Address: | 4308 ALTON ROAD, SUITE 880, Miami Beach, FL, 33140, US |
| Mail Address: | 4585 Nautilus Court, Miami Beach, FL, 33140, US |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447453824 | 2007-06-06 | 2024-11-01 | 4308 ALTON RD STE 880, MIAMI BEACH, FL, 331404560, US | 4308 ALTON RD STE 880, MIAMI BEACH, FL, 331404560, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 305-535-0055 |
| Fax | 8443640130 |
Authorized person
| Name | DR. ARKADIY V. PURYGIN |
| Role | OWNER |
| Phone | 3055350055 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | OS 9336 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2728231 00 |
| State | FL |
| Issuer | BCBS |
| Number | 29414 |
| State | FL |
| Issuer | MEDICARE |
| Number | 29414A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Purygin Arkadiy VDr. | Agent | 4308 Alton Road, Miami Beach, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| Purygin Arkadiy VDr. | Manager | 4308 Alton Road, Miami Beach, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| Purygin Arkadiy VDr. | Director | 4308 Alton Road, Miami Beach, FL, 33140 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000155462 | WOMEN'S HEALTH | ACTIVE | 2020-12-07 | 2025-12-31 | No data | 4585 NAUTILUS COURT, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-18 | 4308 ALTON ROAD, SUITE 880, Miami Beach, FL 33140 | No data |
| CHANGE OF MAILING ADDRESS | 2022-11-20 | 4308 ALTON ROAD, SUITE 880, Miami Beach, FL 33140 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-11-20 | Purygin, Arkadiy V., Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-11-20 | 4308 Alton Road, Suite 880, Miami Beach, FL 33140 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-04-18 |
| AMENDED ANNUAL REPORT | 2022-11-20 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-04-08 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-01-26 |
| ANNUAL REPORT | 2017-02-25 |
| ANNUAL REPORT | 2016-04-14 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7695537302 | 2020-04-30 | 0455 | PPP | 4585 NAUTILUS CT, MIAMI BEACH, FL, 33140-2817 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 01 Feb 2025
Sources: Florida Department of State
