| Entity Name: | BURKE FAMILY MEDICINE P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Jun 2021 (4 years ago) |
| Document Number: | P21000057607 |
| FEI/EIN Number | 871398935 |
| Address: | 2623 S. Seacrest Blvd, Boynton Beach, FL, 33435, US |
| Mail Address: | 2623 S. Seacrest Blvd, Boynton Beach, FL, 33435, US |
| ZIP code: | 33435 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174297295 | 2021-08-03 | 2022-08-26 | 2623 S SEACREST BLVD STE 106, BOYNTON BEACH, FL, 334357531, US | 2623 S SEACREST BLVD STE 106, BOYNTON BEACH, FL, 334357531, US | |||||||||||||||
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| Phone | +1 561-501-1633 |
| Fax | 5619901299 |
Authorized person
| Name | DR. MICHAEL SCOTT BURKE |
| Role | CEO - PRESIDENT |
| Phone | 5615011633 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BURKE MICHAEL SMD | Agent | 2623 S. Seacrest Blvd, Boynton Beach, FL, 33435 |
| Name | Role | Address |
|---|---|---|
| BURKE MICHAEL SMD | Chief Executive Officer | 2623 S. Seacrest Blvd, Boynton Beach, FL, 33435 |
| Name | Role | Address |
|---|---|---|
| BURNS MAIA S | Director | 2623 S. Seacrest Blvd, Boynton Beach, FL, 33435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-04 | 2623 S. Seacrest Blvd, Suite 106, Boynton Beach, FL 33435 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-04 | 2623 S. Seacrest Blvd, Suite 106, Boynton Beach, FL 33435 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-04 | 2623 S. Seacrest Blvd, Suite 106, Boynton Beach, FL 33435 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-06 |
| ANNUAL REPORT | 2023-03-26 |
| ANNUAL REPORT | 2022-04-04 |
| Domestic Profit | 2021-06-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
