| Entity Name: | BOCA RATON PODIATRY & SPORTS MEDICINE INSTITUTE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 May 2019 (6 years ago) |
| Document Number: | P19000043628 |
| FEI/EIN Number | 84-1912657 |
| Mail Address: | 101 Plaza Real S, BOCA RATON, FL, 33432, US |
| Address: | 13455 S Military Trail, Delray Beach, FL, 33484, US |
| ZIP code: | 33484 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982263638 | 2019-06-06 | 2019-06-06 | 5458 TOWN CENTER RD STE 17, BOCA RATON, FL, 334861009, US | 5458 TOWN CENTER RD STE 17, BOCA RATON, FL, 334861009, US | |||||||||||||||
|
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| Phone | +1 561-416-1196 |
| Fax | 5614161822 |
Authorized person
| Name | DR. WAYNE GOLDSTEIN |
| Role | OWNER /PODIATRIST |
| Phone | 5614161196 |
Taxonomy
| Taxonomy Code | 213ES0000X - Sports Medicine Podiatrist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN WAYNE | Agent | 13455 S Military Trail, Delray Beach, FL, 33484 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN WAYNE | President | 13455 S Military Trail, Delray Beach, FL, 33484 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-15 | 13455 S Military Trail, Delray Beach, FL 33484 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-02 | 13455 S Military Trail, A, Delray Beach, FL 33484 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-31 | 13455 S Military Trail, Delray Beach, FL 33484 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| ANNUAL REPORT | 2023-04-02 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-01-22 |
| ANNUAL REPORT | 2020-01-20 |
| Domestic Profit | 2019-05-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
