| Entity Name: | FAMILY MEDICINE ASSOCIATES OF THE EMERALD COAST, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Jul 2002 (23 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P02000076180 |
| FEI/EIN Number | 320022440 |
| Address: | 348 MIRACLE STRIP PARKWAY, SUITE 26, FORT WALTON BEACH, FL, 32548 |
| Mail Address: | PO BOX 1646, DESTIN, FL, 32540 |
| ZIP code: | 32548 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013152487 | 2008-12-12 | 2010-08-31 | PO BOX 1646, DESTIN, FL, 325401646, US | 348 MIRACLE STRIP PKWY SW, SUITE 23, FORT WALTON BEACH, FL, 325485200, US | |||||||||||||||
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| Phone | +1 850-269-2186 |
| Fax | 8502692341 |
Authorized person
| Name | DR. ANA E LEURINDA |
| Role | OWNER/PHYSICIAN |
| Phone | 8502692186 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CARLI DIANA D | Agent | 4012 COMMONS DRIVE WEST, STE 104, DESTIN, FL, 32541 |
| Name | Role | Address |
|---|---|---|
| LEURINDA ANA | President | 348 MIRACLE STRIP PARKWAY SUITE 26, FORT WALTON BEACH, FL, 32548 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-28 | 348 MIRACLE STRIP PARKWAY, SUITE 26, FORT WALTON BEACH, FL 32548 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-28 | 348 MIRACLE STRIP PARKWAY, SUITE 26, FORT WALTON BEACH, FL 32548 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-20 | 4012 COMMONS DRIVE WEST, STE 104, DESTIN, FL 32541 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-04-20 | CARLI, DIANA D | No data |
| REINSTATEMENT | 2007-04-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-04-28 |
| ANNUAL REPORT | 2009-04-28 |
| ANNUAL REPORT | 2008-04-18 |
| REINSTATEMENT | 2007-04-20 |
| ANNUAL REPORT | 2003-02-10 |
| Domestic Profit | 2002-07-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
