| Entity Name: | GERIATRICS OF BOCA - DELRAY PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Mar 2007 (18 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 10 Feb 2011 (14 years ago) |
| Document Number: | P07000035702 |
| FEI/EIN Number | 208661686 |
| Address: | 16244 S Military Trail, DELRAY BEACH, FL, 33484, US |
| Mail Address: | 16244 S Military Trail, DELRAY BEACH, FL, 33484, US |
| ZIP code: | 33484 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073732475 | 2007-04-24 | 2024-02-07 | PO BOX 6972, DELRAY BEACH, FL, 334826972, US | 16244 S MILITARY TRL, DELRAY BEACH, FL, 334846534, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 561-865-5151 |
Authorized person
| Name | MARITZA POLANCO |
| Role | PRESIDENT |
| Phone | 5618438646 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME95737 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 279221400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| POLANCO Hugo | Agent | 2800 BANYAN BLVD, BOCA RATON, FL, 33431 |
| Name | Role | Address |
|---|---|---|
| POLANCO Maritza | Vice President | 16244 S Military Trail, DELRAY BEACH, FL, 33484 |
| Name | Role | Address |
|---|---|---|
| Porras-Polo Ernesto Dr. | Vice Chairman | 16244 S Military Trail, DELRAY BEACH, FL, 33484 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-05-26 | POLANCO, Hugo | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-24 | 16244 S Military Trail, Suite # 470, DELRAY BEACH, FL 33484 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-24 | 16244 S Military Trail, Suite # 470, DELRAY BEACH, FL 33484 | No data |
| NAME CHANGE AMENDMENT | 2011-02-10 | GERIATRICS OF BOCA - DELRAY PA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-19 | 2800 BANYAN BLVD, BOCA RATON, FL 33431 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-24 |
| AMENDED ANNUAL REPORT | 2022-05-26 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-02-24 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-02-28 |
| ANNUAL REPORT | 2017-03-19 |
| ANNUAL REPORT | 2016-03-17 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8559888810 | 2021-04-22 | 0455 | PPS | 16244 S Military Trl Ste 470, Delray Beach, FL, 33484-6532 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 01 Feb 2025
Sources: Florida Department of State
