| Entity Name: | GINA SEVIGNY, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Aug 2001 (24 years ago) |
| Document Number: | P01000076541 |
| FEI/EIN Number | 593734457 |
| Address: | 305 CLYDE MORRIS BLVD STE 150, ORMOND BEACH, FL, 32174 |
| Mail Address: | 1325 OAK FOREST DR, ORMOND BEACH, FL, 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649314212 | 2007-02-16 | 2023-01-24 | 305 CLYDE MORRIS BLVD, SUITE 150, ORMOND BEACH, FL, 321748181, US | 305 CLYDE MORRIS BLVD, SUITE 150, ORMOND BEACH, FL, 321748181, US | |||||||||||||||||
|
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| Phone | +1 386-615-1771 |
Authorized person
| Name | MS. SANDRA M ADAMS |
| Role | MANAGER |
| Phone | 3866151771 |
Taxonomy
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| License Number | ME69303 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SEVIGNY GINA M | Agent | 1325 OAK FOREST DR, ORMOND BEACH, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| SEVIGNY GINA M | Director | 1325 OAK FOREST DR, ORMOND BEACH, FL, 32174 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000001102 | PORT ORANGE DERMATOLOGY | ACTIVE | 2023-01-03 | 2028-12-31 | No data | 1325 OAK FOREST DR, ORMOND BEACH, FL, 32174 |
| G23000001106 | ORMOND BEACH DERMATOLOGY | ACTIVE | 2023-01-03 | 2028-12-31 | No data | 1325 OAK FOREST DR, ORMOND BEACH, FL, 32174 |
| G20000016738 | ORMOND BEACH DERMATOLOGY | ACTIVE | 2020-02-05 | 2025-12-31 | No data | 305 CLYDE MORRIS BLVD STE 150, ORMOND BEACH, FL, 32174--818 |
| G14000101491 | ORMOND BEACH DERMATOLOGY | EXPIRED | 2014-10-06 | 2019-12-31 | No data | 305 CLYDE MORRIS BLVD, SUITE 150, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2006-07-28 | 305 CLYDE MORRIS BLVD STE 150, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-07-28 | 1325 OAK FOREST DR, ORMOND BEACH, FL 32174 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-03-15 | 305 CLYDE MORRIS BLVD STE 150, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-02-21 | SEVIGNY, GINA MMD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-02-12 |
| ANNUAL REPORT | 2015-02-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
