| Entity Name: | PERINATAL AND GYNECOLOGIC SPECIALISTS OF THE PALM BEACHES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Mar 1998 (27 years ago) |
| Document Number: | P98000026321 |
| FEI/EIN Number | 650822349 |
| Address: | 2979 PGA BLVD, #200, PALM BEACH GARDENS, FL, 33410 |
| Mail Address: | 2979 PGA BLVD, #200, 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 | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699880229 | 2006-08-21 | 2013-07-01 | 2979 PGA BLVD, SUITE 200, PALM BEACH GARDENS, FL, 334102911, US | 770 NORTHPOINT PKWY, SUITE 200, WEST PALM BEACH, FL, 334071901, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 561-275-7604 |
| Fax | 5618025385 |
| Phone | +1 561-655-3331 |
| Fax | 5616553744 |
Authorized person
| Name | JOHN A BURIGO |
| Role | VICE PRESIDENT |
| Phone | 5616553331 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | CB7595 |
| State | FL |
| Issuer | MEDICAID |
| Number | 372700900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BURIGO JOHN | Agent | 2979 PGA BLVD, PALMBAECH GARDENS, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| JONES DEBRA | President | 2979 PGA BLVD, #200, PALM BEACH GARDENS, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| JONES DEBRA | Director | 2979 PGA BLVD, #200, PALM BEACH GARDENS, FL, 33410 |
| BURIGO JOHN | Director | 1515 N FLAGLER DR. #7002979 PGA BLVD, #200, PALM BEACH GARDENS, FL, 33410 |
| GORDON ROBERT | Director | 1515 N FLAGLER DR #700, W PALM BCH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| BURIGO JOHN | Vice President | 1515 N FLAGLER DR. #7002979 PGA BLVD, #200, PALM BEACH GARDENS, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| GORDON ROBERT | Treasurer | 1515 N FLAGLER DR #700, W PALM BCH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| Morel Marie | Secretary | 2979 PGA BLVD, #200, PALM BEACH GARDENS, FL, 33410 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09062900261 | PERINATAL SPECIALISTS OF THE PALM BEACHES | EXPIRED | 2009-03-03 | 2014-12-31 | No data | 1515 N. FLAGLER DRIVE, #700, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| NAME CHANGE AMENDMENT | 2003-07-01 | PERINATAL AND GYNECOLOGIC SPECIALISTS OF THE PALM BEACHES, INC. | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
