| Entity Name: | BERNHARD BRIJBAG, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Sep 1998 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Jan 2011 (14 years ago) |
| Document Number: | P98000084003 |
| FEI/EIN Number | 650865839 |
| Address: | 5000 University Drive, 1100, CORAL GABLES, FL, 33146, US |
| Mail Address: | 5000 University Drive, 1100, CORAL GABLES, FL, 33146, US |
| ZIP code: | 33146 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912091141 | 2006-10-03 | 2020-03-11 | 5000 UNIVERSITY DR STE 1100, CORAL GABLES, FL, 331462008, US | 1150 CAMPO SANO AVE, SUITE 420, CORAL GABLES, FL, 331461174, US | |||||||||||||||||||||||||
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| Phone | +1 305-663-0088 |
| Fax | 3056631193 |
Authorized person
| Name | DR. BERNHARD L BRIJBAG |
| Role | PHYSICIAN |
| Phone | 3056630088 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | OS0007081 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 251198300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BRIJBAG BERNHARD | Agent | 5000 University Drive, CORAL GABLES, FL, 33146 |
| Name | Role | Address |
|---|---|---|
| BRIJBAG BERNHARD | Director | 5000 University Drive, CORAL GABLES, FL, 33146 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2018-04-02 | 5000 University Drive, 1100, CORAL GABLES, FL 33146 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-02 | 5000 University Drive, 1100, CORAL GABLES, FL 33146 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-02 | 5000 University Drive, 1100, CORAL GABLES, FL 33146 | No data |
| REINSTATEMENT | 2011-01-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CANCEL ADM DISS/REV | 2006-10-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-02-03 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-04-03 |
| AMENDED ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2018-03-11 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-01-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
