| Entity Name: | ROBERT G. ASHLEY, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 01 Apr 1980 (45 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | 665578 |
| FEI/EIN Number | 59-1981852 |
| Mail Address: | 5422 NW 91st Blvd, Gainesville, FL 32653 |
| Address: | 6800 N.W. 9TH BLVD., SUITE 4, GAINESVILLE, FL 32605 |
| ZIP code: | 32605 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659687507 | 2010-08-28 | 2010-08-28 | 6800 NW 9TH BLVD, SUITE 4, GAINESVILLE, FL, 326054231, US | 6800 NW 9TH BLVD, SUITE 4, GAINESVILLE, FL, 326054231, US | |||||||||||||||||||||||||||||
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| Phone | +1 352-331-3300 |
Authorized person
| Name | DR. ROBERT GRADY ASHLEY JR. |
| Role | PHYSICIAN |
| Phone | 3523313300 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME0020234 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AVMED |
| Number | 100129 |
| State | FL |
| Issuer | BCBS |
| Number | 78194 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ASHLEY, ROBERT G., M.D. | Agent | 5422 NW 91st Blvd, Gainesville, FL 32653 |
| Name | Role | Address |
|---|---|---|
| ASHLEY, ROBERT G. | Director | 5422 NW 91st Blvd, GAINESVILLE, FL 32653 |
| Name | Role | Address |
|---|---|---|
| ASHLEY, ROBERT G. | President | 5422 NW 91st Blvd, GAINESVILLE, FL 32653 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-30 | 6800 N.W. 9TH BLVD., SUITE 4, GAINESVILLE, FL 32605 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-30 | 5422 NW 91st Blvd, Gainesville, FL 32653 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-06-15 | 6800 N.W. 9TH BLVD., SUITE 4, GAINESVILLE, FL 32605 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-27 |
| ANNUAL REPORT | 2020-03-29 |
| ANNUAL REPORT | 2019-04-28 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-03-25 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-22 |
| ANNUAL REPORT | 2014-03-23 |
| ANNUAL REPORT | 2013-03-30 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
