| Entity Name: | DR. CHEN OB/GYN, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Oct 1997 (27 years ago) |
| Document Number: | P97000088492 |
| FEI/EIN Number | 65-0787811 |
| Address: | 5350 W. HILLSBORO BLVD., 102, COCONUT CREEK, FL 33073 |
| Mail Address: | 5350 W. HILLSBORO BLVD., 102, COCONUT CREEK, FL 33073 |
| ZIP code: | 33073 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346618832 | 2015-09-14 | 2015-09-14 | 5350 W HILLSBORO BLVD, STE. 102, COCONUT CREEK, FL, 330734396, US | 5350 W HILLSBORO BLVD, STE. 102, COCONUT CREEK, FL, 330734396, US | |||||||||||||||||||||||||
|
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| Phone | +1 954-725-7660 |
| Fax | 9547257605 |
Authorized person
| Name | YING YING ALICE CHEN |
| Role | OFFICE MANAGER |
| Phone | 9547257660 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME68694 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 252850903 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHEN, YIH-MIN | Agent | 5350 W Hillsboro Blvd. Ste. 102, Coconut Creek, FL 33064 |
| Name | Role | Address |
|---|---|---|
| Chen, Yih-Min, Dr. | President | 3850 NE 26th Ave, Lighthouse Point, FL 33064 |
| Name | Role | Address |
|---|---|---|
| Chen, Kir-Wei, Dr. | Chief Executive Officer | 6797 NW 110 Way, Parkland, FL 33076 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-10 | 5350 W Hillsboro Blvd. Ste. 102, Coconut Creek, FL 33064 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-20 | 5350 W. HILLSBORO BLVD., 102, COCONUT CREEK, FL 33073 | No data |
| CHANGE OF MAILING ADDRESS | 2011-03-20 | 5350 W. HILLSBORO BLVD., 102, COCONUT CREEK, FL 33073 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-02-26 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-10 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-15 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-04-16 |
| ANNUAL REPORT | 2015-04-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
