| Entity Name: | STONE SURGERY CLINIC, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 Apr 2006 (19 years ago) |
| Branch of: | STONE SURGERY CLINIC, L.L.C., MISSISSIPPI (Company Number 669968) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | M06000001895 |
| FEI/EIN Number | 562637409 |
| Address: | 962 HWY 331 S., DEFUNIAK SPRINGS, FL, 32435 |
| Mail Address: | 962 HWY 331 S., DEFUNIAK SPRINGS, FL, 32435 |
| ZIP code: | 32435 |
| County: | Walton |
| Place of Formation: | MISSISSIPPI |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073718664 | 2007-06-15 | 2020-08-22 | 4417 US HWY 331 S, DEFUNIAK SPRINGS, FL, 324356703, US | 4417 US HWY 331 S, DEFUNIAK SPRINGS, FL, 324356703, US | |||||||||||||||||||
|
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| Phone | +1 850-951-4638 |
| Fax | 8509514554 |
Authorized person
| Name | DONNA WARD |
| Role | OFFICE MANAGER |
| Phone | 8509514638 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| License Number | 3024682 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FAWAZ FAWZI M | Agent | 962 HWY 331 S, DEFUNIAK SPRINGS, FL, 324353372 |
| Name | Role | Address |
|---|---|---|
| FAWAZ FAWZI M | Managing Member | 962 US HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 324353372 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-01-26 | 962 HWY 331 S, DEFUNIAK SPRINGS, FL 32435-3372 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-09-24 | 962 HWY 331 S., DEFUNIAK SPRINGS, FL 32435 | No data |
| CHANGE OF MAILING ADDRESS | 2008-09-24 | 962 HWY 331 S., DEFUNIAK SPRINGS, FL 32435 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-09-24 | FAWAZ, FAWZI M.D. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-26 |
| ANNUAL REPORT | 2010-04-04 |
| ANNUAL REPORT | 2009-01-28 |
| ANNUAL REPORT | 2008-09-24 |
| ANNUAL REPORT | 2007-04-23 |
| Foreign Limited | 2006-04-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
