| Entity Name: | FELIPE E DOMINGUEZ, MD, PA. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Jan 2008 (17 years ago) |
| Document Number: | P08000000338 |
| FEI/EIN Number | 061832642 |
| Address: | 3030 Venture Lane Ste 108, Melbourne, FL, 32934, US |
| Mail Address: | 725 SPRINGLAKE DR, MELBOURNE, FL, 32940, US |
| ZIP code: | 32934 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871874974 | 2011-09-01 | 2014-12-18 | 14040 US HIGHWAY 1, SEBASTIAN, FL, 32958, US | 3030 VENTURE LANE, STE 108, MELBOURNE, FL, 32934, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 772-581-0890 |
| Fax | 7725810591 |
| Phone | +1 321-253-5197 |
| Fax | 3212535199 |
Authorized person
| Name | FELIPE E DOMINGUEZ |
| Role | PRESIDENT |
| Phone | 3217951321 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | ME 48985 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DOMINGUEZ FELIPE E | Agent | 725 SPRINGLAKE DR, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| DOMINGUEZ FELIPE E | President | 725 SPRINGLAKE DR, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-10 | 3030 Venture Lane Ste 108, Melbourne, FL 32934 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-03-05 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-06-14 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-07-13 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
