| Entity Name: | BRIAN J. INGLERIGHT, D.O., INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Inactive |
| Date Filed: | 23 Jan 2006 (19 years ago) |
| Date of dissolution: | 19 Jun 2020 (5 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 19 Jun 2020 (5 years ago) |
| Document Number: | F06000000517 |
| FEI/EIN Number | 352200613 |
| Address: | 5575 GULF BLVD, #338, ST PETE BEACH, FL, 33706, US |
| Mail Address: | 5575 GULF BLVD, #338, ST PETE BEACH, FL, 33706, US |
| ZIP code: | 33706 |
| County: | Pinellas |
| Place of Formation: | OHIO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770671216 | 2006-10-10 | 2008-10-21 | 14540 CORTEZ BLVD, SUITE 104, BROOKSVILLE, FL, 346136056, US | 14540 CORTEZ BLVD, SUITE 104, BROOKSVILLE, FL, 346136056, US | |||||||||||||||||||||||||
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| Phone | +1 352-592-1243 |
| Fax | 3525921246 |
Authorized person
| Name | DR. BRIAN J INGLERIGHT |
| Role | PRESIDENT |
| Phone | 3525921243 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS6103 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274813400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| INGLERIGHT BRIAN J | President | 5575 Gulf Blvd, St Pete Beach, FL, 33706 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000052044 | ST. PETE TATTOO REMOVAL | EXPIRED | 2014-05-29 | 2019-12-31 | No data | 5575 GULF BLVD #338, ST PETE BEACH, FL, 33706 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2020-06-19 | No data | No data |
| REGISTERED AGENT CHANGED | 2020-06-19 | REGISTERED AGENT REVOKED | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-25 | 5575 GULF BLVD, #338, ST PETE BEACH, FL 33706 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-25 | 5575 GULF BLVD, #338, ST PETE BEACH, FL 33706 | No data |
| Name | Date |
|---|---|
| Withdrawal | 2020-06-19 |
| ANNUAL REPORT | 2019-03-20 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-19 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-02-25 |
| ANNUAL REPORT | 2013-01-07 |
| ANNUAL REPORT | 2012-01-09 |
| ANNUAL REPORT | 2011-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
