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  5. WILJON W. BELTRE MD, PA

WILJON W. BELTRE MD, PA

Company Details

Entity Name: WILJON W. BELTRE MD, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 11 Aug 2010 (14 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 09 Oct 2013 (11 years ago)
Document Number: P10000065890
FEI/EIN Number 273519099
Address: 1101 N Maitland Ave, Maitland, FL, 32751, US
Mail Address: 1101 N Maitland Ave, Maitland, FL, 32751, US
ZIP code: 32751
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1124227988 2007-07-12 2011-03-29 106 BOSTON AVE STE 206, ALTAMONTE SPRINGS, FL, 327014712, US 106 BOSTON AVE, SUITE 206, ALTAMONTE SPRINGS, FL, 327014731, US

Contacts
Phone +1 407-830-6868
Fax 4078307801

Authorized person
Name DR. WILJON W BELTRE
Role OWNER
Phone 4078306868

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
License Number ME76567
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 256082800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WILJON W. BELTRE, MD, PA 401(K) PLAN 2023 273519099 2024-05-06 WILJON W. BELTRE, MD, PA 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 1101 N MAITLAND AVE, MAITLAND, FL, 32751
WILJON W. BELTRE, MD, PA 401(K) PLAN 2022 273519099 2023-09-18 WILJON W. BELTRE, MD, PA 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 106 BOSTON AVE., # 209, ALTAMONTE SPRINGS, FL, 32701
WILJON W. BELTRE, MD, PA 401(K) PLAN 2021 273519099 2022-09-19 WILJON W. BELTRE, MD, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 106 BOSTON AVE., # 209, ALTAMONTE SPRINGS, FL, 32701
WILJON W. BELTRE, MD, PA 401(K) PLAN 2020 273519099 2021-10-13 WILJON W. BELTRE, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 106 BOSTON AVE., # 209, ALTAMONTE SPRINGS, FL, 32701
WILJON W. BELTRE, MD, PA 401(K) PLAN 2019 273519099 2020-10-01 WILJON W. BELTRE, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 106 BOSTON AVE., # 209, ALTAMONTE SPRINGS, FL, 32701
WILJON W. BELTRE, MD, PA 401(K) PLAN 2018 273519099 2019-10-14 WILJON W. BELTRE, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 106 BOSTON AVE., # 209, ALTAMONTE SPRINGS, FL, 32701
WILJON W. BELTRE, MD, PA 401(K) PLAN 2017 273519099 2018-10-11 WILJON W. BELTRE, MD, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3212289704
Plan sponsor’s address 745 ORIENTA AVE, STE 1041, ALTAMONTE SPRINGS, FL, 32701

Agent

Name Role Address
BELTRE WILJON M Agent 1101 N Maitland Ave, Maitland, FL, 32751

President

Name Role Address
BELTRE WILJON W President 176 Vista Oak Dr., Longwood, FL, 32779

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000135548 BELTRE BARIATRICS ACTIVE 2022-10-31 2027-12-31 No data 1101 N MAITLAND AVE, MAITLAND, FL, 32751
G22000120163 CENTER FOR METABOLIC AND OBESITY SURGERY ACTIVE 2022-09-22 2027-12-31 No data 106 BOSTON AVE. SUITE 209, ALTAMONTE SPRINGS, FL, 32701
G20000126343 BELTRE BARIATRICS ACTIVE 2020-09-29 2025-12-31 No data 106 BOSTON AVE, SUITE 209, ALTAMONTE SPRINGS, FL, 32701
G16000139080 CENTER FOR METABOLIC AND OBESITY SURGERY EXPIRED 2016-12-27 2021-12-31 No data 106 BOSTON AVE. SUITE 209, ALTAMONTE SPRINGS, FL, 32701

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-01-19 1101 N Maitland Ave, Maitland, FL 32751 No data
CHANGE OF MAILING ADDRESS 2023-01-19 1101 N Maitland Ave, Maitland, FL 32751 No data
REGISTERED AGENT ADDRESS CHANGED 2023-01-19 1101 N Maitland Ave, Maitland, FL 32751 No data
REGISTERED AGENT NAME CHANGED 2018-01-11 BELTRE, WILJON MD No data
REINSTATEMENT 2013-10-09 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 No data No data

Documents

Name Date
ANNUAL REPORT 2024-02-04
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-03-02
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-01-11
ANNUAL REPORT 2017-01-15
ANNUAL REPORT 2016-01-21
ANNUAL REPORT 2015-01-10

Related by officers

BELTRE WILJON W

470 W. CENTRAL PARKWAY, LLC MAITLAND SURGERY CENTER LLC CARIBEX LLC BELTRE FAMILY PARTNERSHIP LLLP ADVANCED SURGICAL WEIGHT LOSS INC WILJON W. BELTRE, M.D., P.A.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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