| Entity Name: | TIMBER CREEK CONSULTANTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 24 Jun 2003 (22 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P03000071033 |
| FEI/EIN Number | 200124851 |
| Address: | 6434 NW 42ND ROAD, GAINESVILLE, FL, 32606, US |
| Mail Address: | 6434 NW 42ND ROAD, GAINESVILLE, FL, 32606, US |
| ZIP code: | 32606 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801859236 | 2006-04-07 | 2009-12-15 | 6434 NW 42ND RD, GAINESVILLE, FL, 326064280, US | 6434 NW 42ND RD, GAINESVILLE, FL, 326064280, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-378-8934 |
| Fax | 3523721169 |
Authorized person
| Name | MRS. KATHRYN BATTEN GLAZER |
| Role | PRESIDENT/OWNER |
| Phone | 3523788934 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| License Number | ARNP450192 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 306748300 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | P00209328 |
| State | FL |
| Issuer | BCBS |
| Number | E3107 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GLAZER KATHRYN B | Agent | 6434 NW 42ND ROAD, GAINESVILLE, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| GLAZER KATHRYN B | Director | 6434 NW 42ND ROAD, GAINESVILLE, FL, 32606 |
| GLAZER NATHAN W | Director | 6434 NW 42ND RD, GAINESVILLE, FL, 32606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-06-06 | 6434 NW 42ND ROAD, GAINESVILLE, FL 32606 | No data |
| CHANGE OF MAILING ADDRESS | 2009-06-06 | 6434 NW 42ND ROAD, GAINESVILLE, FL 32606 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-13 |
| ANNUAL REPORT | 2011-05-17 |
| ANNUAL REPORT | 2010-08-22 |
| ANNUAL REPORT | 2009-06-06 |
| ANNUAL REPORT | 2008-03-17 |
| ANNUAL REPORT | 2007-02-11 |
| ANNUAL REPORT | 2006-02-27 |
| ANNUAL REPORT | 2005-01-15 |
| ANNUAL REPORT | 2004-01-22 |
| Domestic Profit | 2003-06-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
