| Entity Name: | SEIJAS MEDICAL CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 05 Aug 2003 (21 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P03000085228 |
| FEI/EIN Number | 90-0102177 |
| Address: | 411 SAINT JOHNS AVENUE, PALATKA, FL 32177 |
| Mail Address: | 411 SAINT JOHNS AVENUE, PALATKA, FL 32177 |
| ZIP code: | 32177 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407042948 | 2007-09-19 | 2008-11-11 | PO BOX 3123, ST AUGUSTINE, FL, 320853123, US | 411 SAINT JOHNS AVE, PALATKA, FL, 321774724, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-824-4990 |
| Fax | 9048242226 |
| Phone | +1 386-325-1700 |
| Fax | 3863251702 |
Authorized person
| Name | ANA MARIE SEIJAS |
| Role | OWNER |
| Phone | 3863251700 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME71326 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 252983100 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DD5869 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DE LA TORRE, ROBERT | Agent | 149 WEERTS ROAD, SAN MATEO, FL 32187 |
| Name | Role | Address |
|---|---|---|
| SEIJAS, ANA M | Director | 411 ST. JOHNS AVE, PALATKA, FL 32177 |
| DE LA TORRE, ROBERT | Director | 149 WEERTS ROAD, SAN MATEO, FL 32187 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-03-28 | DE LA TORRE, ROBERT | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-03-28 | 149 WEERTS ROAD, SAN MATEO, FL 32187 | No data |
| REINSTATEMENT | 2007-03-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-07-07 | 411 SAINT JOHNS AVENUE, PALATKA, FL 32177 | No data |
| CHANGE OF MAILING ADDRESS | 2004-07-07 | 411 SAINT JOHNS AVENUE, PALATKA, FL 32177 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-04-30 |
| REINSTATEMENT | 2007-03-28 |
| ANNUAL REPORT | 2005-02-05 |
| ANNUAL REPORT | 2004-07-07 |
| Domestic Profit | 2003-08-05 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
