| Entity Name: | ENDOCRINOLOGY & DIABETES ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Jan 1993 (32 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2020 (4 years ago) |
| Document Number: | P93000001313 |
| FEI/EIN Number | 65-0379416 |
| Address: | 1505university drive, suite300, CORAL SPRINGS, FL 33071 |
| Mail Address: | 1505university drive, suite300, CORAL SPRINGS, FL 33071 |
| ZIP code: | 33071 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780844803 | 2008-06-12 | 2012-04-25 | 1801 N UNIVERSITY DR, SUITE209, CORAL SPRINGS, FL, 330718920, US | 1801 N UNIVERSITY DR, SUITE209, CORAL SPRINGS, FL, 330718920, US | |||||||||||||||||||||||||||
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| Phone | +1 954-575-4040 |
| Fax | 9545754049 |
Authorized person
| Name | DR. VIVIAN PERCIVAL ROSE |
| Role | PRESIDENT |
| Phone | 9545754040 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UPIN |
| Number | D63185 |
| State | FL |
| Issuer | MEDICAID |
| Number | 0475769 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROSE, VIVIAN | Agent | 1505university drive, suite300, CORAL SPRINGS, FL 33071 |
| Name | Role | Address |
|---|---|---|
| ROSE, VIVIAN P | President | 1505university drive, suite300 CORAL SPRINGS, FL 33071 |
| Name | Role | Address |
|---|---|---|
| ROSE, VIVIAN P | Director | 1505university drive, suite300 CORAL SPRINGS, FL 33071 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2020-09-30 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-09-30 | ROSE, VIVIAN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-08-02 | 1505university drive, suite300, CORAL SPRINGS, FL 33071 | No data |
| CHANGE OF MAILING ADDRESS | 2013-08-02 | 1505university drive, suite300, CORAL SPRINGS, FL 33071 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-08-02 | 1505university drive, suite300, CORAL SPRINGS, FL 33071 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-04-06 |
| REINSTATEMENT | 2020-09-30 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-03-25 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
