| Entity Name: | WAKULLA URGENT CARE & DIAGNOSTIC CENTER PLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Nov 2005 (19 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 18 Oct 2011 (13 years ago) |
| Document Number: | L05000114006 |
| FEI/EIN Number | 203850058 |
| Address: | 41 FELI WAY, CRAWFORDVILLE, FL, 32327, US |
| Mail Address: | 41 FELI WAY, CRAWFORDVILLE, FL, 32327, US |
| ZIP code: | 32327 |
| County: | Wakulla |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215509344 | 2021-07-16 | 2021-07-16 | 41 FELI WAY, CRAWFORDVILLE, FL, 323272368, US | 41 FELI WAY, CRAWFORDVILLE, FL, 323272368, US | |||||||||||||||||||||
|
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| Phone | +1 850-926-3140 |
| Fax | 8509263163 |
Authorized person
| Name | DAVID ANTHONY KEEN |
| Role | MANAGER |
| Phone | 8509263140 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002074401 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KEEN DAVID | Agent | 41 FELI WAY, CRAWFORDVILLE, FL, 32327 |
| Name | Role | Address |
|---|---|---|
| KEEN DAVID | Manager | 41 FELI WAY, CRAWFORDVILLE, FL, 32327 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-14 | 41 FELI WAY, CRAWFORDVILLE, FL 32327 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-14 | 41 FELI WAY, CRAWFORDVILLE, FL 32327 | No data |
| CHANGE OF MAILING ADDRESS | 2014-03-14 | 41 FELI WAY, CRAWFORDVILLE, FL 32327 | No data |
| REINSTATEMENT | 2011-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CANCEL ADM DISS/REV | 2008-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2007-12-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-02-22 |
| ANNUAL REPORT | 2016-02-11 |
| ANNUAL REPORT | 2015-01-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
