| Entity Name: | THOMAS J. MANSKI, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 18 Dec 2003 (21 years ago) |
| Date of dissolution: | 27 Aug 2020 (4 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 27 Aug 2020 (4 years ago) |
| Document Number: | P03000153198 |
| FEI/EIN Number | 200497040 |
| Address: | 350 RACETRACK RD N.W., FT WALTON BEACH, FL, 32547, US |
| Mail Address: | 350 RACETRACK RD N.W., FT WALTON BEACH, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174536551 | 2006-08-15 | 2007-07-19 | 350 RACETRACK RD NW, FORT WALTON BEACH, FL, 325471554, US | 350 RACETRACK RD NW, FORT WALTON BEACH, FL, 325471554, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 850-863-2300 |
| Fax | 8508632369 |
Authorized person
| Name | DR. THOMAS MANSKI |
| Role | PHYSICIAN/OWNER |
| Phone | 8508632300 |
Taxonomy
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| License Number | ME79275 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MANSKI THOMAS J | Agent | 350 RACETRACK RD N.W., FT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| MANSKI THOMAS JMD | Director | 350 RACETRACK RD N.W., FT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2020-08-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-21 | 350 RACETRACK RD N.W., FT WALTON BEACH, FL 32547 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-21 | 350 RACETRACK RD N.W., FT WALTON BEACH, FL 32547 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-04-17 | MANSKI, THOMAS J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-17 | 350 RACETRACK RD N.W., FT WALTON BEACH, FL 32547 | No data |
| Name | Date |
|---|---|
| CORAPVDWN | 2020-08-27 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-03-22 |
| ANNUAL REPORT | 2011-04-21 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
