| Entity Name: | ROBERT BORREGO, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 08 Dec 1995 (29 years ago) |
| Document Number: | P95000093533 |
| FEI/EIN Number | 65-0637845 |
| Address: | 2560 RCA BOULEVARD, PALM BEACH GARDENS, FL 33410 |
| Mail Address: | 2560 RCA BOULEVARD, PALM BEACH GARDENS, FL 33410 |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427319060 | 2012-05-30 | 2012-05-30 | 3375 BURNS RD, SUITE 206, PALM BEACH GARDENS, FL, 334104349, US | 3375 BURNS RD, SUITE 206, PALM BEACH GARDENS, FL, 334104349, US | |||||||||||||||||||||||||
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| Phone | +1 561-799-9559 |
| Fax | 5617999577 |
Authorized person
| Name | DR. ROBERT BORREGO |
| Role | OWNER |
| Phone | 5617999559 |
Taxonomy
| Taxonomy Code | 2086S0127X - Trauma Surgery Physician |
| License Number | 57542 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 057824000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BORREGO, ROBERT MD PA | Agent | 2560 RCA BLVD, SUITE 106, PALM BEACH GARDENS, FL 33410 |
| Name | Role | Address |
|---|---|---|
| BORREGO, ROBERT | Manager | 2560 RCA BLVD, Suite 106 PALM BEACH GARDENS, FL 33410 |
| Name | Role | Address |
|---|---|---|
| BORREGO, ROBERT | Director | 2560 RCA BLVD, Suite 106 PALM BEACH GARDENS, FL 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-30 | 2560 RCA BLVD, SUITE 106, PALM BEACH GARDENS, FL 33410 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-12-12 | 2560 RCA BOULEVARD, PALM BEACH GARDENS, FL 33410 | No data |
| CHANGE OF MAILING ADDRESS | 2022-12-12 | 2560 RCA BOULEVARD, PALM BEACH GARDENS, FL 33410 | No data |
| REGISTERED AGENT NAME CHANGED | 1996-07-05 | BORREGO, ROBERT MD PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-24 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-03-01 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-02-19 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-15 |
| ANNUAL REPORT | 2016-02-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
