| Entity Name: | MOISES DOBARGANES ARNP, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 30 Jan 2015 (10 years ago) |
| Document Number: | P15000009856 |
| FEI/EIN Number | 47-2993102 |
| Address: | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 |
| Mail Address: | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356734396 | 2015-03-16 | 2021-08-22 | 4883 PALM COAST PKWY NW UNIT 1, PALM COAST, FL, 321373675, US | 4883 PALM COAST PKWY NW UNIT 1, PALM COAST, FL, 321373675, US | |||||||||||||||||||||||||||
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| Phone | +1 386-585-4556 |
| Fax | 3865854529 |
Authorized person
| Name | MOISES DOBARGANES |
| Role | PRESIDENT |
| Phone | 3865854556 |
Taxonomy
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010602200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 015501800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DOBARGANES, MOISES | Agent | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 |
| Name | Role | Address |
|---|---|---|
| DOBARGANES, MOISES | President | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 |
| Name | Role | Address |
|---|---|---|
| DOBARGANES, MOISES | Vice President | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000024170 | DOBAR MEDICAL | ACTIVE | 2017-03-06 | 2027-12-31 | No data | 4883 PALM COAST PKWY NW UNIT 1, PALM COAST, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-12 | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-12 | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-12 | 4883 Palm Coast Pkwy NW Unit 1, Palm Coast, FL 32137 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-03-12 |
| ANNUAL REPORT | 2022-03-12 |
| ANNUAL REPORT | 2021-03-19 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-03-20 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-03-06 |
| ANNUAL REPORT | 2016-03-23 |
| Domestic Profit | 2015-01-30 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
