| Entity Name: | COLEEN L DOOLEY ARNP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 21 Sep 2010 (14 years ago) |
| Document Number: | L10000098872 |
| FEI/EIN Number | 27-3660090 |
| Address: | 300 Southard,, SUITE 102, KEY WEST, FL 33040 |
| Mail Address: | PO BOX 420346, SUMMERLAND KEY, FL 33042 |
| ZIP code: | 33040 |
| County: | Monroe |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558661322 | 2010-10-27 | 2010-10-27 | PO BOX 420346, SUMMERLAND KEY, FL, 330420346, US | 2409 N ROOSEVELT BLVD, SUITE 6, KEY WEST, FL, 330403837, US | |||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-745-8215 |
Authorized person
| Name | COLEEN L DOOLEY |
| Role | DIRECTOR/SOLE PROVIDER |
| Phone | 3057453768 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| License Number | ARNP 624842 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| License Number | ARNP 624842 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI TYPE 2 |
| Number | 1659496958 |
| State | FL |
| Issuer | NPI TYPE 1 |
| Number | 1972660082 |
| Issuer | MEDICAID |
| Number | 034293900 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | Y3409 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DOOLEY, COLEEN L | Agent | 300 Southard,, SUITE 102, KEY WEST, FL 33040 |
| Name | Role | Address |
|---|---|---|
| DOOLEY, COLEEN L | Managing Member | 300 Southard St, 102 KEY WEST, FL 33040 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-28 | 300 Southard,, SUITE 102, KEY WEST, FL 33040 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-28 | 300 Southard,, SUITE 102, KEY WEST, FL 33040 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-08-21 | DOOLEY, COLEEN L | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-26 | 300 Southard,, SUITE 102, KEY WEST, FL 33040 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-28 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-01-26 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-01-14 |
| ANNUAL REPORT | 2016-03-13 |
| ANNUAL REPORT | 2015-03-18 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4120497309 | 2020-04-29 | 0455 | PPP | 2409 North Roosevelt Blvd #6, KEY WEST, FL, 33040-3924 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 23 Feb 2025
Sources: Florida Department of State
