| Entity Name: | KATHLEEN M. CARROLL, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Oct 2003 (21 years ago) |
| Date of dissolution: | 12 Feb 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 12 Feb 2021 (4 years ago) |
| Document Number: | P03000112429 |
| FEI/EIN Number | 200307262 |
| Address: | 336 BLOOMINGDALE AVE, BRANDON, FL, 33511-8155 |
| Mail Address: | 336 BLOOMINGDALE AVE, BRANDON, FL, 33511-8155 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891983094 | 2007-10-12 | 2007-10-12 | 336 E BLOOMINGDALE AVE, BRANDON, FL, 335118155, US | 336 E BLOOMINGDALE AVE, BRANDON, FL, 335118155, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 813-689-2466 |
| Fax | 8136890435 |
Authorized person
| Name | DR. KATHLEEN M CARROLL |
| Role | PHYSICIAN |
| Phone | 8136892466 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CARROLL KATHLEEN M | Agent | 336 BLOOMINGDALE AVE, BRANDON, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| CARROLL KATHLEEN M | Director | 336 BLOOMINGDALE AVE, BRANDON, FL, 335118155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-02-12 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-01-12 | CARROLL, KATHLEEN MMD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-02-11 | 336 BLOOMINGDALE AVE, BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-02-12 |
| ANNUAL REPORT | 2020-04-09 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-09 |
| ANNUAL REPORT | 2014-01-21 |
| ANNUAL REPORT | 2013-01-28 |
| ANNUAL REPORT | 2012-01-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
