| Entity Name: | MARIANNA MEDICAL ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
MARIANNA MEDICAL ASSOCIATES, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 02 May 2000 (25 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P00000044244 |
| FEI/EIN Number |
593647692
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4349 LAFAYETTE ST, MARIANNA, FL, 32446 |
| Mail Address: | P.O. BOX 758, MARIANNA, FL, 32447, US |
| ZIP code: | 32446 |
| County: | Jackson |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225184930 | 2007-01-26 | 2022-07-21 | 4349 LAFAYETTE ST, MARIANNA, FL, 324462915, US | 4349 LAFAYETTE ST, MARIANNA, FL, 324462915, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 850-372-4460 |
| Fax | 8503724461 |
Authorized person
| Name | DR. DANIEL E FULMER |
| Role | PRESIDENT |
| Phone | 8503724460 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 45308 |
| State | FL |
| Issuer | MEDICAID |
| Number | 259105700 |
| State | FL |
| Issuer | BLUE CROSS CLUE SHIELD |
| Number | 6SALA |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FULMER DANIEL E | Director | 4349 lafayette st, MARIANNA, FL, 32446 |
| Howard Timothy CPA | Agent | 857 S.Edgewood Avenue, Jacksonville, FL, 32205 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2018-01-23 | Howard, Timothy, CPA | - |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-14 | 857 S.Edgewood Avenue, Jacksonville, FL 32205 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-28 | 4349 LAFAYETTE ST, MARIANNA, FL 32446 | - |
| CHANGE OF MAILING ADDRESS | 2003-04-22 | 4349 LAFAYETTE ST, MARIANNA, FL 32446 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-01-14 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-01-31 |
| ANNUAL REPORT | 2012-02-09 |
| ANNUAL REPORT | 2011-02-16 |
| ANNUAL REPORT | 2010-04-28 |
| ANNUAL REPORT | 2009-02-02 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
