| Entity Name: | NAPLES GYNECOLOGY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Nov 2011 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Oct 2013 (11 years ago) |
| Document Number: | L11000129613 |
| FEI/EIN Number | 45-3802709 |
| Address: | 810 Anchor Rode Drive, NAPLES, FL, 34103, US |
| Mail Address: | 2564 Kona Way, NAPLES, FL, 34120, US |
| ZIP code: | 34103 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073889028 | 2012-03-23 | 2012-03-23 | 1012 GOODLETTE RD N, SUITE 101, NAPLES, FL, 341025463, US | 1012 GOODLETTE RD N, SUITE 101, NAPLES, FL, 341025463, US | |||||||||||||||||||||||||
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| Phone | +1 239-214-9111 |
| Fax | 2393301360 |
Authorized person
| Name | DR. BLANE MITCHELL CRANDALL |
| Role | OWNER/PHYSICIAN |
| Phone | 2392139111 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME95903 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 01893701 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CRANDALL BLANE M | Agent | 810 Anchor Rode Drive, NAPLES, FL, 34103 |
| Name | Role | Address |
|---|---|---|
| CRANDALL BLANE M | Managing Member | 810 Anchor Rode Drive, NAPLES, FL, 34103 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-24 | 810 Anchor Rode Drive, NAPLES, FL 34103 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-24 | 810 Anchor Rode Drive, NAPLES, FL 34103 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-24 | 810 Anchor Rode Drive, NAPLES, FL 34103 | No data |
| REINSTATEMENT | 2013-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REINSTATEMENT | 2012-10-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-06-16 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-06 |
| ANNUAL REPORT | 2015-03-31 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
