| Entity Name: | GEORGE F. ELLIS, MD, INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Feb 2004 (21 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P04000031201 |
| FEI/EIN Number | 200698416 |
| Address: | 92 WISTERIA DRIVE, LONGWOOD, FL, 32779 |
| Mail Address: | 92 WISTERIA DRIVE, LONGWOOD, FL, 32779 |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760436844 | 2006-05-21 | 2020-08-22 | 92 WISTERIA DR, LONGWOOD, FL, 327794956, US | 1400 S ORLANDO AVE, SUITE 202, WINTER PARK, FL, 327895543, US | |||||||||||||||||||||
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| Phone | +1 407-928-8866 |
| Fax | 8665081691 |
| Phone | +1 407-580-3940 |
Authorized person
| Name | DR. GEORGE FREDERICK ELLIS |
| Role | PRESIDENT |
| Phone | 4075803940 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| License Number | ME49437 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ELLIS GEORGE F | Agent | 92 WISTERIA DRIVE, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| ELLIS GEORGE F | President | 92 WISTERIA DRIVE, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| ELLIS GEORGE F | Secretary | 92 WISTERIA DRIVE, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| ELLIS GEORGE F | Treasurer | 92 WISTERIA DRIVE, LONGWOOD, FL, 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-02-17 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-01-10 |
| ANNUAL REPORT | 2011-01-10 |
| ANNUAL REPORT | 2010-01-12 |
| ANNUAL REPORT | 2009-03-05 |
| ANNUAL REPORT | 2008-02-25 |
| ANNUAL REPORT | 2007-04-16 |
| ANNUAL REPORT | 2006-04-25 |
| ANNUAL REPORT | 2005-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
