| Entity Name: | TERESITA L. REPIEDAD M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 29 Sep 1980 (44 years ago) |
| Date of dissolution: | 17 Dec 2018 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 17 Dec 2018 (6 years ago) |
| Document Number: | 689338 |
| FEI/EIN Number | 59-2031464 |
| Address: | 1216 S.E. 24TH ROAD, OCALA, FL 34471 |
| Mail Address: | 1216 S.E. 24TH ROAD, OCALA, FL 34471 |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093010563 | 2011-01-14 | 2011-02-15 | 1216 SE 24TH RD, OCALA, FL, 344716010, US | 1216 SE 24TH RD, OCALA, FL, 344716010, US | |||||||||||||||||||||||||
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| Phone | +1 352-351-0647 |
| Fax | 3526221342 |
Authorized person
| Name | TERESITA L REPIEDAD |
| Role | OWNER/PRESIDENT |
| Phone | 3523510647 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0033930 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 039258800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| REPIEDAD, TERESITA L MD | Agent | 1216 S.E. 24TH ROAD, OCALA, FL 32671 |
| Name | Role | Address |
|---|---|---|
| REPIEDAD, TERESITA L | Director | 1216 S.E. 24TH ROAD, OCALA, FL |
| Name | Role | Address |
|---|---|---|
| REPIEDAD, AGUINALDO V | Vice President | 1216 S.E. 24TH ROAD, OCALA, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-12-17 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-03-13 | 1216 S.E. 24TH ROAD, OCALA, FL 34471 | No data |
| CHANGE OF MAILING ADDRESS | 2006-03-13 | 1216 S.E. 24TH ROAD, OCALA, FL 34471 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2000-02-17 | 1216 S.E. 24TH ROAD, OCALA, FL 32671 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2018-12-17 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-05-17 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-20 |
| ANNUAL REPORT | 2014-01-09 |
| ANNUAL REPORT | 2013-03-22 |
| ANNUAL REPORT | 2012-03-19 |
| ANNUAL REPORT | 2011-03-21 |
| ANNUAL REPORT | 2010-02-26 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
