| Entity Name: | BRIAN THORNBURG, DO, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Jan 2006 (19 years ago) |
| Document Number: | P06000001336 |
| FEI/EIN Number | 204045275 |
| Address: | 5500 BRYSON DRIVE, SUITE 301A, NAPLES, FL, 34109, US |
| Mail Address: | 5500 BRYSON DRIVE, SUITE 301A, NAPLES, FL, 34109, US |
| ZIP code: | 34109 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598130197 | 2015-12-08 | 2016-12-28 | 5500 BRYSON DR, SUITE 301, NAPLES, FL, 341090922, US | 5500 BRYSON DR, SUITE 301, NAPLES, FL, 341090922, US | |||||||||||||||||||||||||
|
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| Phone | +1 239-348-7337 |
| Fax | 2393487391 |
Authorized person
| Name | DR. JAMES BRIAN THORNBURG |
| Role | OWNER |
| Phone | 2393487337 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | OS9029 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI FOR PROVIDER |
| Number | 1588702419 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THORNBURG BRIAN | Agent | 5500 BRYSON DRIVE, NAPLES, FL, 34109 |
| Name | Role | Address |
|---|---|---|
| THORNBURG BRIAN DR. | Director | 5500 BRYSON DRIVE, NAPLES, FL, 34109 |
| Name | Role | Address |
|---|---|---|
| THORNBURG BRIAN DR. | President | 5500 BRYSON DRIVE, NAPLES, FL, 34109 |
| Name | Role | Address |
|---|---|---|
| THORNBURG BRIAN DR. | Secretary | 5500 BRYSON DRIVE, NAPLES, FL, 34109 |
| Name | Role | Address |
|---|---|---|
| THORNBURG BRIAN DR. | Treasurer | 5500 BRYSON DRIVE, NAPLES, FL, 34109 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000090631 | THORNBURG PEDIATRICS | ACTIVE | 2015-09-02 | 2025-12-31 | No data | 5500 BRYSON DRIVE, NAPLES, FL, 34109 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-10 | 5500 BRYSON DRIVE, SUITE 301A, NAPLES, FL 34109 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-10 | 5500 BRYSON DRIVE, SUITE 301A, NAPLES, FL 34109 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-10 | 5500 BRYSON DRIVE, SUITE 301A, NAPLES, FL 34109 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-05-09 | THORNBURG, BRIAN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-04-10 |
| ANNUAL REPORT | 2019-01-10 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-01-16 |
| AMENDED ANNUAL REPORT | 2016-01-19 |
| ANNUAL REPORT | 2016-01-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
