| Entity Name: | WPB MEDICAL PROVIDER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Sep 2013 (11 years ago) |
| Document Number: | P13000074108 |
| FEI/EIN Number | 46-3617771 |
| Address: | 3405 NW Federal Highway, Jensen Beach, FL 34957 |
| Mail Address: | 3405 NW Federal Highway, Jensen Beach, FL 34957 |
| ZIP code: | 34957 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043625718 | 2014-06-21 | 2014-06-21 | 464 FERN ST, WEST PALM BEACH, FL, 334015818, US | 464 FERN ST, WEST PALM BEACH, FL, 334015818, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 561-822-2000 |
Authorized person
| Name | MRS. COLLEEN PARKHURST |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 5618222000 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | 3201662 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| David, Weinberger | Agent | 3405 NW Federal Hwy, Jensen Beach, FL 34957 |
| Name | Role | Address |
|---|---|---|
| Weinberger, David | President | 3405 NW Federal Hwy, Jensen Beach, FL 34957 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-04-05 | David, Weinberger | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-05 | 3405 NW Federal Hwy, Jensen Beach, FL 34957 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-18 | 3405 NW Federal Highway, Jensen Beach, FL 34957 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-16 | 3405 NW Federal Highway, Jensen Beach, FL 34957 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-03-18 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-03-22 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-02-02 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
