| Entity Name: | MARY M. COLBURN, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Jun 1998 (27 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 11 Jul 2023 (2 years ago) |
| Document Number: | P98000058684 |
| FEI/EIN Number | 650850760 |
| Address: | 400 EXECUTIVE CTR DR, STE 102, WEST PALM BEACH, FL, 33401 |
| Mail Address: | 400 EXECUTIVE CTR DR, STE 102, WEST PALM BEACH, FL, 33401 |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255638961 | 2011-02-15 | 2011-02-15 | 400 EXECUTIVE CENTER DR, SUITE 102, WEST PALM BEACH, FL, 334012917, US | 400 EXECUTIVE CENTER DR, SUITE 102, WEST PALM BEACH, FL, 334012917, US | |||||||||||||||||||
|
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| Phone | +1 561-683-2220 |
| Fax | 5616833885 |
Authorized person
| Name | DR. MARY M. COLBURN |
| Role | ONWER/PRESIDENT |
| Phone | 5616832220 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME0071775 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Colburn Mary M | Agent | 400 EXECUTIVE CTR DR, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| COLBURN MARY M | Director | 400 EXECUTIVE CTR DR, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-07-11 | Colburn, Mary M | No data |
| REINSTATEMENT | 2023-07-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2011-10-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2001-07-26 | 400 EXECUTIVE CTR DR, 102, WEST PALM BEACH, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2000-05-19 | 400 EXECUTIVE CTR DR, STE 102, WEST PALM BEACH, FL 33401 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2000-05-19 | 400 EXECUTIVE CTR DR, STE 102, WEST PALM BEACH, FL 33401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| REINSTATEMENT | 2023-07-11 |
| ANNUAL REPORT | 2018-03-15 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-02-03 |
| ANNUAL REPORT | 2014-01-16 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-01-13 |
| REINSTATEMENT | 2011-10-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
