| Entity Name: | ARTHUR A. MAUCERI M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 18 Sep 1975 (49 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | 484660 |
| FEI/EIN Number | 59-1618575 |
| Address: | 6831 N.W. 11TH PLACE, SUITE 2, GAINESVILLE, FL 32605 |
| Mail Address: | 6831 N.W. 11TH PLACE, SUITE 2, GAINESVILLE, FL 32605 |
| ZIP code: | 32605 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720338353 | 2012-09-11 | 2012-09-11 | 6831 NW 11TH PL, SUITE 2, GAINESVILLE, FL, 326054249, US | 6831 NW 11TH PL, SUITE 2, GAINESVILLE, FL, 326054249, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-331-3650 |
| Fax | 3523316000 |
Authorized person
| Name | ARTHUR ANGELO MAUCERI |
| Role | PRESIDENT |
| Phone | 3525513650 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME12375 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 050232400 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | 111072699 |
| State | FL |
| Issuer | BCBS FL |
| Number | 01173 |
| State | FL |
| Issuer | AVMED |
| Number | 215651 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MAUCERI, ARTHUR AMD | Agent | 6831 N.W. 11TH PLACE, SUITE 2, GAINESVILLE, FL 32605 |
| Name | Role | Address |
|---|---|---|
| MAUCERI, ARTHUR AMD | President | 6831 NW 11TH PLACE, GAINESVILLE, FL 32605 |
| Name | Role | Address |
|---|---|---|
| MAUCERI, ARTHUR AMD | Secretary | 6831 NW 11TH PLACE, GAINESVILLE, FL 32605 |
| Name | Role | Address |
|---|---|---|
| MAUCERI, ARTHUR AMD | Director | 6831 NW 11TH PLACE, GAINESVILLE, FL 32605 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-31 | 6831 N.W. 11TH PLACE, SUITE 2, GAINESVILLE, FL 32605 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-10 | 6831 N.W. 11TH PLACE, SUITE 2, GAINESVILLE, FL 32605 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-02-10 | MAUCERI, ARTHUR AMD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-02 | 6831 N.W. 11TH PLACE, SUITE 2, GAINESVILLE, FL 32605 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-01-09 |
| ANNUAL REPORT | 2012-01-31 |
| ANNUAL REPORT | 2011-02-10 |
| ANNUAL REPORT | 2010-02-11 |
| ANNUAL REPORT | 2009-02-02 |
| ANNUAL REPORT | 2008-01-10 |
| ANNUAL REPORT | 2007-01-11 |
| ANNUAL REPORT | 2006-01-18 |
Date of last update: 06 Feb 2025
Sources: Florida Department of State
