| Entity Name: | WILLIAM J. ROMANOS, JR., M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 13 Oct 1976 (48 years ago) |
| Date of dissolution: | 13 Jul 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 13 Jul 2022 (3 years ago) |
| Document Number: | 516693 |
| FEI/EIN Number | 59-1712660 |
| Address: | 1304 Sonoma Court, Palm Beach Gardens, FL 33410 |
| Mail Address: | 1304 Sonoma Court, 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 | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891036521 | 2013-03-05 | 2013-03-05 | 900 S US HIGHWAY 1, SUITE 101, JUPITER, FL, 334776459, US | 900 S US HIGHWAY 1, SUITE 101, JUPITER, FL, 334776459, US | |||||||||||||||||||||||||||||
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| Phone | +1 561-746-7224 |
| Fax | 5617433329 |
Authorized person
| Name | MS. SANDRA M. WALDRON |
| Role | BILLING ADMINISTRATOR |
| Phone | 7722210190 |
Taxonomy
| Taxonomy Code | 2084P0802X - Addiction Psychiatry Physician |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0805X - Geriatric Psychiatry Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 78167 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Probst, Daniel J | Agent | 800 Village Square Crossing, Suite 214, Palm Beach Gardens, FL 33410 |
| Name | Role | Address |
|---|---|---|
| Irelan, Gerilan A. | President | 1304 Sonoma Court, Palm Beach Gardens, FL 33410 |
| Name | Role | Address |
|---|---|---|
| Irelan, Gerilan A. | Director | 1304 Sonoma Court, Palm Beach Gardens, FL 33410 |
| Name | Role | Address |
|---|---|---|
| Probst, Daniel J | Authorized Representative | 800 Village Square Crossing, Suite 214 Palm Beach Gardens, FL 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-07-13 | No data | No data |
| REINSTATEMENT | 2022-05-29 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-05-29 | 1304 Sonoma Court, Palm Beach Gardens, FL 33410 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-29 | 800 Village Square Crossing, Suite 214, Palm Beach Gardens, FL 33410 | No data |
| CHANGE OF MAILING ADDRESS | 2022-05-29 | 1304 Sonoma Court, Palm Beach Gardens, FL 33410 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-05-29 | Probst, Daniel J | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-07-13 |
| REINSTATEMENT | 2022-05-29 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-04-21 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-04-20 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-17 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
