| Entity Name: | COUNTRYSIDE MEDICAL CENTER ASSOCIATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 18 Jul 1983 (42 years ago) |
| Document Number: | 769423 |
| FEI/EIN Number | 592557924 |
| Address: | 944 BRIDGEWATER DRIVE, PORT ORANGE, FL, 32127, US |
| Mail Address: | c/o Legal Department, 303 North Clyde Morris Blvd., Daytona Beach, FL, 32114, US |
| ZIP code: | 32127 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| KWIATEK KELLY | Agent | c/o Legal Department, Daytona Beach, FL, 32114 |
| Name | Role | Address |
|---|---|---|
| PANCZYSZYN MICHAEL | Vice President | 938 BRIDGEWATER DRIVE, PORT ORANGE, FL, 32127 |
| Name | Role | Address |
|---|---|---|
| PANCZYSZYN MICHAEL | Director | 938 BRIDGEWATER DRIVE, PORT ORANGE, FL, 32127 |
| STAUDT EDWARD D | Director | 944 BRIDGEWATER DR, PORT ORANGE, FL, 32127 |
| GRIFFIN WILLIAM | Director | 303 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Name | Role | Address |
|---|---|---|
| GRIFFIN WILLIAM | President | 303 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2005-12-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
| REINSTATEMENT | 1992-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1990-11-09 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
