| Entity Name: | THE EAR, NOSE & THROAT CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Sep 2002 (22 years ago) |
| Date of dissolution: | 11 Nov 2021 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 11 Nov 2021 (3 years ago) |
| Document Number: | P02000099070 |
| FEI/EIN Number | 760714569 |
| Address: | 5753 Hwy 85 North #6955, Crestview, FL, 32536, US |
| Mail Address: | 5753 Hwy 85 North #6955, Crestview, FL, 32536, US |
| ZIP code: | 32536 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902920101 | 2007-03-16 | 2010-12-02 | 7915 BAY STREET, SEBASTIAN, FL, 32958, US | 7915 BAY ST, SEBASTIAN, FL, 329583282, US | |||||||||||||||||||||||||
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| Phone | +1 772-581-3687 |
| Fax | 7725813680 |
Authorized person
| Name | DR. JOSEPH ALBERT NINKE |
| Role | PRESIDENT |
| Phone | 7725813687 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME85949 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 265617500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NINKE JOSEPH A | Agent | 5753 Hwy 85 North #6955, Crestview, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| NINKE JOSEPH A | Director | 5753 Hwy 85 North #6955, Crestview, FL, 32536 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-11-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-02 | 5753 Hwy 85 North #6955, Crestview, FL 32536 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-02 | 5753 Hwy 85 North #6955, Crestview, FL 32536 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-02 | 5753 Hwy 85 North #6955, Crestview, FL 32536 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-11-11 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-05-02 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-01-22 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-03-15 |
| ANNUAL REPORT | 2015-05-01 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-03-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
