| Entity Name: | COLLABORATIVE PHYSICIANS GROUP, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 01 May 2018 (7 years ago) |
| Document Number: | P18000040620 |
| FEI/EIN Number | 83-0541950 |
| Mail Address: | 515 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Address: | 900 GLADES RD, SUITE 1-A, BOCA RATON, FL 33431 |
| ZIP code: | 33431 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306338835 | 2018-05-31 | 2022-08-18 | 505 S FEDERAL HWY, DEERFIELD BEACH, FL, 334414109, US | 900 GLADES RD STE 1A, BOCA RATON, FL, 334316405, US | |||||||||||||||||
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| Phone | +1 954-363-0088 |
| Fax | 4124518656 |
| Phone | +1 954-421-6242 |
Authorized person
| Name | MR. RAMI SLEIMAN |
| Role | COO |
| Phone | 7817995524 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SLEIMAN, RAMI | Agent | 515 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| ABU-MOUSTAFA, SHERIEF | Director | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| ABU-MOUSTAFA, ADEL | Director | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| ABU-MOUSTAFA, SHERIEF | President | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| ABU-MOUSTAFA, SHERIEF | Chief Executive Officer | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| ABU-MOUSTAFA, ADEL | Vice President | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| SLEIMAN, RAMI | Chief Operating Officer | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| BRANSTETTER, TODD | Chief Financial Officer | 530 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-01 | 900 GLADES RD, SUITE 1-A, BOCA RATON, FL 33431 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-01 | SLEIMAN, RAMI | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-01 | 515 S. FEDERAL HIGHWAY, DEERFIELD BEACH, FL 33441 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-22 | 900 GLADES RD, SUITE 1-A, BOCA RATON, FL 33431 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-01-19 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-07-23 |
| ANNUAL REPORT | 2019-04-22 |
| Domestic Profit | 2018-05-01 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
