| Entity Name: | GOOD SHEPHERD PRIMARY CARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Jan 2000 (25 years ago) |
| Date of dissolution: | 06 Mar 2009 (16 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 06 Mar 2009 (16 years ago) |
| Document Number: | P00000005908 |
| FEI/EIN Number | 593619883 |
| Address: | 1170 S. SEMORAN BLVD., STE D, ORLANDO, FL, 32807 |
| Mail Address: | 1170 S. SEMORAN BLVD., STE D, ORLANDO, FL, 32807 |
| ZIP code: | 32807 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306048343 | 2007-06-01 | 2007-07-18 | 1170 S SEMORAN BLVD, SUITE D, ORLANDO, FL, 328071458, US | 1170 S SEMORAN BLVD, SUITE D, ORLANDO, FL, 328071458, US | |||||||||||||||||||
|
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| Phone | +1 407-282-4142 |
| Fax | 4072827475 |
Authorized person
| Name | DR. MARIBEL AVILES |
| Role | PRESIDENT |
| Phone | 4072824142 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0066465 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AVILES MARIBEL | Agent | 13650 CRISTAL RIVER DR., ORLANDO, FL, 32828 |
| Name | Role | Address |
|---|---|---|
| AVILES MARIBEL | Director | 1170 S SEMORAN BLVD.,SUITE D, ORLANDO, FL, 32807 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2009-03-06 | No data | No data |
| CANCEL ADM DISS/REV | 2005-05-03 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-05-03 | 13650 CRISTAL RIVER DR., ORLANDO, FL 32828 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-02-17 | 1170 S. SEMORAN BLVD., STE D, ORLANDO, FL 32807 | No data |
| CHANGE OF MAILING ADDRESS | 2003-02-17 | 1170 S. SEMORAN BLVD., STE D, ORLANDO, FL 32807 | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2009-03-06 |
| ANNUAL REPORT | 2008-04-21 |
| ANNUAL REPORT | 2007-04-26 |
| ANNUAL REPORT | 2006-03-23 |
| REINSTATEMENT | 2005-05-03 |
| ANNUAL REPORT | 2003-02-17 |
| ANNUAL REPORT | 2002-10-25 |
| ANNUAL REPORT | 2001-04-26 |
| Domestic Profit | 2000-01-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
