| Entity Name: | ANTHONY DECOTIS, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
ANTHONY DECOTIS, M.D., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 29 Dec 1988 (36 years ago) |
| Document Number: | K54504 |
| FEI/EIN Number |
592918630
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 131 BEAL PKWY NW, FT WALTON BCH, FL, 32548, US |
| Mail Address: | 131 BEAL PKWY NW, FT WALTON BCH, FL, 32548, US |
| ZIP code: | 32548 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881930857 | 2012-12-19 | 2012-12-19 | 131 BEAL PKWY NW, FORT WALTON BEACH, FL, 325484358, US | 131 BEAL PKWY NW, FORT WALTON BEACH, FL, 325484358, US | |||||||||||||||||||||||||||||||
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| Phone | +1 850-243-8558 |
| Fax | 8503010147 |
Authorized person
| Name | DR. ANTHONY DECOTIS |
| Role | PRESIDENT/PHYSICIAN |
| Phone | 8502438558 |
Taxonomy
| Taxonomy Code | 207RR0500X - Rheumatology Physician |
| License Number | ME45093 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 047222100 |
| State | FL |
| Issuer | BLUE COSS BLUE SHIELD OF FLORIDA |
| Number | 17617 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DECOTIS, ANTHONY MD | Director | 131 NW BEAL PKWY, FT WALTON BEACH, FL, 32548 |
| DECOTIS ANTHONY MD | Agent | 131 BEAL PARKWAY NW, FT WALTON BCH, FL, 32548 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2009-03-25 | 131 BEAL PKWY NW, FT WALTON BCH, FL 32548 | - |
| REGISTERED AGENT ADDRESS CHANGED | 1999-04-26 | 131 BEAL PARKWAY NW, FT WALTON BCH, FL 32548 | - |
| CHANGE OF PRINCIPAL ADDRESS | 1997-05-05 | 131 BEAL PKWY NW, FT WALTON BCH, FL 32548 | - |
| REGISTERED AGENT NAME CHANGED | 1997-05-05 | DECOTIS, ANTHONY MD | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-25 |
| ANNUAL REPORT | 2020-06-14 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-28 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5190017109 | 2020-04-13 | 0491 | PPP | 131 Beal Parkway NW, FORT WALTON BEACH, FL, 32548-4358 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 May 2025
Sources: Florida Department of State
