| Entity Name: | INDIAN ROCKS MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 09 Jun 1999 (26 years ago) |
| Date of dissolution: | 25 Sep 2009 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (16 years ago) |
| Document Number: | N99000003595 |
| FEI/EIN Number |
593587767
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| Mail Address: | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| ZIP code: | 33774 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629075874 | 2005-07-01 | 2020-08-22 | 12685 ULMERTON RD, LARGO, FL, 337743603, US | 12685 ULMERTON RD, LARGO, FL, 337743603, US | |||||||||||||||||||
|
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| Phone | +1 727-593-8700 |
| Fax | 7275938701 |
Authorized person
| Name | SAMARA L VANDERGRAFF |
| Role | OFFICE MANAGER |
| Phone | 7275938700 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | OS0007369 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HARRELL GLENN | Director | 12685 ULMERTON RD., LARGO, FL, 33774 |
| JOHNSON KARIN | Director | 12685 ULMERTON RD., LARGO, FL, 33774 |
| JOHNSON KARIN | Secretary | 12685 ULMERTON RD., LARGO, FL, 33774 |
| DIAZ FERNANDO | Director | 12685 ULMERTON RD., LARGO, FL, 33774 |
| JANECKI CHET | Director | 12685 ULMERTON RD, LARGO, FL, 33774 |
| JONES KELLY | Treasurer | 12685 ULMERTON RD., LARGO, FL, 33774 |
| FERGUSON TIMOTHY | President | 12685 ULMERTON RD., LARGO, FL, 33774 |
| FERGUSON TIMOTHY A | Agent | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2007-05-03 | 12685 ULMERTON ROAD, LARGO, FL 33774 | - |
| CHANGE OF MAILING ADDRESS | 2007-05-03 | 12685 ULMERTON ROAD, LARGO, FL 33774 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2007-05-03 | 12685 ULMERTON ROAD, LARGO, FL 33774 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-05-02 |
| ANNUAL REPORT | 2007-05-03 |
| ANNUAL REPORT | 2006-05-03 |
| ANNUAL REPORT | 2005-05-02 |
| ANNUAL REPORT | 2004-04-30 |
| ANNUAL REPORT | 2003-05-05 |
| ANNUAL REPORT | 2002-02-17 |
| ANNUAL REPORT | 2001-02-09 |
| ANNUAL REPORT | 2000-05-15 |
| Domestic Non-Profit | 1999-06-11 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
