| Entity Name: | EDWARD FETHEROLF, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
EDWARD FETHEROLF, M.D., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 31 Dec 2003 (21 years ago) |
| Date of dissolution: | 26 Sep 2014 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (11 years ago) |
| Document Number: | P04000000963 |
| FEI/EIN Number |
200545408
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1500 PLACIDA RD, SUITE B2, ENGLEWOOD, FL, 34223 |
| Mail Address: | 1273 SOUTHBAY DR, OSPREY, FL, 34229 |
| ZIP code: | 34223 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730378282 | 2007-10-22 | 2015-05-13 | 1500 PLACIDA RD, SUITE B2, ENGLEWOOD, FL, 342234955, US | 1500 PLACIDA RD, SUITE B2, ENGLEWOOD, FL, 342234955, US | |||||||||||||||||||||||||
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| Phone | +1 941-474-2266 |
| Fax | 9414757274 |
Authorized person
| Name | DR. EDWARD C FETHEROLF |
| Role | PRESIDENT |
| Phone | 9414742266 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME30596 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 374759000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PRIDEMORE & ASSOCIATES, CPAS, PA | Agent | 229 TAMIAMI TRAIL S, VENICE, FL, 34285 |
| FETHEROLF EDWARD | Director | 1273 SOUTHBAY DR, OSPREY, FL, 34229 |
| FETHEROLF EDWARD | President | 1273 SOUTHBAY DR, OSPREY, FL, 34229 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | - | - |
| CANCEL ADM DISS/REV | 2006-09-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2006-09-27 | PRIDEMORE & ASSOCIATES, CPAS, PA | - |
| REGISTERED AGENT ADDRESS CHANGED | 2006-09-27 | 229 TAMIAMI TRAIL S, VENICE, FL 34285 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2004-04-22 | 1500 PLACIDA RD, SUITE B2, ENGLEWOOD, FL 34223 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-03-31 |
| ANNUAL REPORT | 2012-03-29 |
| ANNUAL REPORT | 2011-04-28 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-29 |
| ANNUAL REPORT | 2008-02-11 |
| ANNUAL REPORT | 2007-07-16 |
| REINSTATEMENT | 2006-09-27 |
| ANNUAL REPORT | 2005-08-10 |
| ANNUAL REPORT | 2004-04-22 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
