| Entity Name: | PAUL CAPOBIANCO, DO, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Mar 2023 (2 years ago) |
| Document Number: | P23000017273 |
| FEI/EIN Number | 92-2892891 |
| Address: | 1820 NE JENSEN BEACH BLVD. #512, JENSEN BEACH, FL 34957 |
| Mail Address: | 1820 NE JENSEN BEACH BLVD. #512, JENSEN BEACH, FL 34957 |
| ZIP code: | 34957 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730879354 | 2023-05-08 | 2023-05-08 | 1820 NE JENSEN BEACH BLVD # 512, JENSEN BEACH, FL, 349577212, US | 3472 NE SAVANNAH RD, JENSEN BEACH, FL, 349573758, US | |||||||||||||||||
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| Phone | +1 516-435-5260 |
Authorized person
| Name | PAUL JAMES CAPOBIANCO |
| Role | PHYSICIAN |
| Phone | 5164355260 |
Taxonomy
| Taxonomy Code | 204D00000X - Neuromusculoskeletal Medicine & OMM Physician |
| Is Primary | Yes |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CAPOBIANCO, PAUL | Agent | 1820 NE JENSEN BEACH BLVD. #512, JENSEN BEACH, FL 34957 |
| Name | Role | Address |
|---|---|---|
| CAPOBIANCO, PAUL | Director | 1820 NE JENSEN BEACH BLVD. #512, JENSEN BEACH, FL 34957 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| Domestic Profit | 2023-03-06 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
