| Entity Name: | ANDREW CHANG, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Apr 2022 (3 years ago) |
| Document Number: | P22000035361 |
| FEI/EIN Number | 88-2309961 |
| Address: | 2336 SE OCEAN BLVD, #30, STUART, FL, 34996 |
| Mail Address: | 2336 SE OCEAN BLVD, #30, STUART, FL, 34996 |
| ZIP code: | 34996 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376277962 | 2022-07-11 | 2023-06-15 | 2336 SE OCEAN BLVD # 30, STUART, FL, 349963310, US | 5850 SE COMMUNITY DR, STUART, FL, 349976420, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 847-961-0599 |
Authorized person
| Name | ANDREW CHANG |
| Role | OWNER |
| Phone | 2444656592 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHANG ANDREW | Agent | 2336 SE OCEAN BLVD, STUART, FL, 34996 |
| Name | Role | Address |
|---|---|---|
| CHANG ANDREW | President | 2336 SE OCEAN BLVD, STUART, FL, 34996 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-19 |
| ANNUAL REPORT | 2023-03-01 |
| Domestic Profit | 2022-04-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
