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MARCELLO A. BORZATTA, M.D., PA - Florida Company Profile

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Company Details

Entity Name: MARCELLO A. BORZATTA, M.D., PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 02 Feb 2007 (19 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 14 Oct 2023 (2 years ago)
Document Number: P07000015399
FEI/EIN Number 208441629
Address: 2260 SO FERDON BLVD, CRESTVIEW, FL, 32536, US
Mail Address: 2260 SO FERDON BLVD, CRESTVIEW, FL, 32536, US
ZIP code: 32536
City: Crestview
County: Okaloosa
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BORZATTA MARCELLO A President 2260 SO FERDON BLVD,, CRESTVIEW, FL, 32536
BORZATTA MARCELLO A Secretary 2260 SO FERDON BLVD,, CRESTVIEW, FL, 32536
BORZATTA MARCELLO A Treasurer 2260 SO FERDON BLVD,, CRESTVIEW, FL, 32536
Marcello Borzatta ADr. Agent 2260 SO FERDON BLVD, CRESTVIEW, FL, 32536

National Provider Identifier

NPI Number:
1609090158
Certification Date:
2024-05-24

Authorized Person:

Name:
MARCELLO A BORZATTA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2086S0129X - Vascular Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2396633061

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000057874 GULFCOAST VASCULAR & WOUND CARE ACTIVE 2024-05-01 2029-12-31 - 2260 S FERDON BLVD, CRESTVIEW, FL, 32536

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-04 2260 SO FERDON BLVD, CRESTVIEW, FL 32536 -
CHANGE OF MAILING ADDRESS 2024-04-04 2260 SO FERDON BLVD, CRESTVIEW, FL 32536 -
REGISTERED AGENT ADDRESS CHANGED 2024-04-04 2260 SO FERDON BLVD, CRESTVIEW, FL 32536 -
REINSTATEMENT 2023-10-14 - -
REGISTERED AGENT NAME CHANGED 2023-10-14 Marcello, Borzatta A, Dr. -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J11000239868 TERMINATED 1000000211543 OKALOOSA 2011-04-13 2021-04-20 $ 1,318.86 STATE OF FLORIDA, DEPARTMENT OF REVENUE, PENSACOLA SERVICE CENTER, 3670 N L ST STE C, PENSACOLA FL325055254

Documents

Name Date
ANNUAL REPORT 2024-04-04
REINSTATEMENT 2023-10-14
ANNUAL REPORT 2022-04-25
ANNUAL REPORT 2021-07-16
ANNUAL REPORT 2020-02-13
ANNUAL REPORT 2019-05-13
ANNUAL REPORT 2018-04-10
ANNUAL REPORT 2017-04-16
ANNUAL REPORT 2016-02-28
ANNUAL REPORT 2015-01-19

USAspending Awards / Financial Assistance

Date:
2020-04-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
20800.00
Total Face Value Of Loan:
20800.00
Date:
2020-04-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
20800.00
Total Face Value Of Loan:
20800.00

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$20,800
Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$20,800
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$21,101.46
Servicing Lender:
Community Bank of Mississippi
Use of Proceeds:
Payroll: $20,800

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Date of last update: 03 Aug 2025

Sources: Florida Department of State