| Entity Name: | PBD&P, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 May 1998 (27 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 22 Jan 2003 (22 years ago) |
| Document Number: | P98000048503 |
| FEI/EIN Number | 650846826 |
| Address: | 701 NORTHPOINT PARKWAY, STE 300, WEST PALM BEACH, FL, 33407, US |
| Mail Address: | 701 NORTHPOINT PARKWAY, STE 300, WEST PALM BEACH, FL, 33407, US |
| ZIP code: | 33407 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689640328 | 2006-02-23 | 2012-05-04 | 4475 MEDICAL CENTER WAY, SUITE 1, WEST PALM BEACH, FL, 334073240, US | 4475 MEDICAL CENTER WAY, SUITE 2, WEST PALM BEACH, FL, 334073240, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 561-840-0995 |
| Fax | 5618400661 |
Authorized person
| Name | DANIEL O SOKOLOFF |
| Role | PRESIDENT |
| Phone | 5618400995 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS GROUP NUMBER |
| Number | 21482 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FARRELL JAMES A | Agent | 7330 W Lake Dr, WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| Rosenberg Steven P | Director | 701 Northpoint Parkway Ste 300, West Palm Beach, FL, 33407 |
| KOWALCZYK JOHN P | Director | 701 Northpoint Parkway Ste 300, WEST PALM BEACH, FL, 33407 |
| DIBACCO ROBERT S | Director | 701 Northpoint Parkway Ste 300, WEST PALM BEACH, FL, 33407 |
| Muhart Michelle E | Director | 701 Northpoint Parkway Ste 300, WEST PALM BEACH, FL, 33407 |
| Kishor Sowmya I | Director | 701 Northpoint Parkway Ste 300, WEST PALM BEACH, FL, 33407 |
| Lifshitz Oren P | Director | 701 Northpoint Parkway Ste 300, West Palm Beach, FL, 33407 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000006940 | PALM BEACH DERMATOLOGY | ACTIVE | 2017-01-19 | 2027-12-31 | No data | 701 NORTHPOINT PARKWAY STE 300, WEST PALM BEACH, FL, 33407 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-13 | 7330 W Lake Dr, WEST PALM BEACH, FL 33406 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-12-07 | 701 NORTHPOINT PARKWAY, STE 300, WEST PALM BEACH, FL 33407 | No data |
| CHANGE OF MAILING ADDRESS | 2021-12-07 | 701 NORTHPOINT PARKWAY, STE 300, WEST PALM BEACH, FL 33407 | No data |
| AMENDMENT | 2003-01-22 | No data | No data |
| NAME CHANGE AMENDMENT | 2000-12-29 | PBD&P, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
