| Entity Name: | AMBERPET Y. RATHNAM, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 Mar 2009 (16 years ago) |
| Document Number: | P09000026695 |
| FEI/EIN Number | 26-4526125 |
| Address: | 6765 SUNSET STRIP, SUITES 6 & 7, SUNRISE, FL 33313 |
| Mail Address: | 6765 SUNSET STRIP, SUITES 6 & 7, SUNRISE, FL 33313 |
| ZIP code: | 33313 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578292322 | 2022-06-07 | 2023-09-06 | 6765 SUNSET STRIP STE 6 &7, SUNRISE, FL, 333132894, US | 6765 SUNSET STRIP STE 6&7, SUNRISE, FL, 333132894, US | |||||||||||||||||||||
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| Phone | +1 954-572-7755 |
| Fax | 9545727799 |
Authorized person
| Name | DR. AMBERPET Y. RATHNAM |
| Role | MEDICAL DOCTOR |
| Phone | 9545727755 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 119339300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RATHNAM, AMBERPET Y | Agent | 6765 SUNSET STRIP, SUITES 6 & 7, SUNRISE, FL 33313 |
| Name | Role | Address |
|---|---|---|
| RATHNAM, AMBERPET Y | President | 6765 SUNSET STRIP, SUITES 6 & 7, SUNRISE, FL 33313 |
| Name | Role | Address |
|---|---|---|
| RATHNAM, AMBERPET Y | Secretary | 6765 SUNSET STRIP, SUITES 6 & 7, SUNRISE, FL 33313 |
| Name | Role | Address |
|---|---|---|
| RATHNAM, AMBERPET Y | Treasurer | 6765 SUNSET STRIP, SUITES 6 & 7, SUNRISE, FL 33313 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09084900210 | PEDIATRIC ASSOCIATES OF SUNRISE | EXPIRED | 2009-03-25 | 2014-12-31 | No data | 6765 SUNSET STRIP, SUITE 6 & 7, SUNRISE, FL, 33313 |
| G09084900206 | SUNSHINE PEDIATRICS | EXPIRED | 2009-03-25 | 2014-12-31 | No data | 6765 SUNSET STRIP, SUITE 6 & 7, SUNRISE, FL, 33313 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-01 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-03-07 |
| ANNUAL REPORT | 2018-02-21 |
| ANNUAL REPORT | 2017-07-03 |
| ANNUAL REPORT | 2016-02-25 |
| ANNUAL REPORT | 2015-02-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3920257104 | 2020-04-12 | 0455 | PPP | 6765 SUNSET STRIP STE 6 & 7, FORT LAUDERDALE, FL, 33313 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 24 Feb 2025
Sources: Florida Department of State
