| Entity Name: | ELEANOR A. MCCAIN, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Aug 1986 (38 years ago) |
| Document Number: | J30091 |
| FEI/EIN Number | 592784358 |
| Address: | 116 Truxton Avenue, FORT WALTON BEACH, FL, 32547, US |
| Mail Address: | 116 Truxton Avenue, FORT WALTON BEACH, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528255114 | 2007-09-27 | 2007-09-27 | 918 MAR WALT DR, FORT WALTON BEACH, FL, 325476706, US | 918 MAR WALT DR, FORT WALTON BEACH, FL, 325476706, US | |||||||||||||||||||
|
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| Phone | +1 850-863-8812 |
| Fax | 8508643817 |
Authorized person
| Name | DR. ELEANOR A. MCCAIN |
| Role | OWNER |
| Phone | 8508638812 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME0044529 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MCCAIN, ELEANOR A. | Agent | 87 MEIGS DRIVE, SHALIMAR, FL, 32579 |
| Name | Role | Address |
|---|---|---|
| MCCAIN, ELEANOR A. | Director | 87 MEIGS DR., SHALIMAR, FL, 32579 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 1995-09-25 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
