| Entity Name: | ADELINA C. FLORES, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Apr 1981 (44 years ago) |
| Document Number: | F21426 |
| FEI/EIN Number | 592066923 |
| Address: | 2400 HARBOR BLVD, SUITE 12, PORT CHARLOTTE, FL, 33952 |
| Mail Address: | 2400 HARBOR BLVD, SUITE 12, PORT CHARLOTTE, FL, 33952 |
| ZIP code: | 33952 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598076143 | 2010-06-29 | 2010-06-29 | 2400 HARBOR BLVD, SUITE 12, PORT CHARLOTTE, FL, 339525052, US | 2400 HARBOR BLVD, SUITE 12, PORT CHARLOTTE, FL, 339525052, US | |||||||||||||||||||||||||
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| Phone | +1 941-629-4422 |
| Fax | 9416273084 |
Authorized person
| Name | DR. ADELINA C FLORES |
| Role | OWNER |
| Phone | 9416294422 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME33549 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI 1649253733 DONE IN 2006 |
| Number | 1649253733 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FLORES, ADELINA C | Agent | 2400 HARBOR BLVD., STE 12, PORT CHARLOTTE, FL, 33952 |
| Name | Role | Address |
|---|---|---|
| FLORES, ADELINA C | Director | 2400 HARBOR BLVD., SUITE 12, PORT CHARLOTTE, FL 00000 |
| Name | Role | Address |
|---|---|---|
| FLORES, ADELINA C | President | 2400 HARBOR BLVD., SUITE 12, PORT CHARLOTTE, FL 00000 |
| Name | Role | Address |
|---|---|---|
| FLORES, ADELINA C | Secretary | 2400 HARBOR BLVD., SUITE 12, PORT CHARLOTTE, FL 00000 |
| Name | Role | Address |
|---|---|---|
| FLORES, ADELINA C | Treasurer | 2400 HARBOR BLVD, SUITE 12, PORT CHARLOTTE, FL 00000 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REINSTATEMENT | 2010-10-25 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
