| Entity Name: | KATHLEEN L. TODD, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Jun 2004 (21 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P04000090003 |
| FEI/EIN Number | 201227616 |
| Address: | 406 Lake Howell Road, Maitland, FL, 32751, US |
| Mail Address: | 406 Lake Howell Road, Maitland, FL, 32751, US |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255524344 | 2007-08-22 | 2014-05-07 | 406 LAKE HOWELL RD, MAITLAND, FL, 32751, US | 406 LAKE HOWELL RD, MAITLAND, FL, 32751, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-691-3960 |
| Fax | 4076913961 |
Authorized person
| Name | DR. KATHLEEN L TODD |
| Role | PHYSICIAN |
| Phone | 4076785554 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS7722 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FAMILY PRACTICE |
| Number | OS7722 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YERGEY DAVID AJR | Agent | 211 N MAGNOLIA AVE, ORLANDO, FL, 32801 |
| Name | Role | Address |
|---|---|---|
| TODD KATHLEEN L | Director | 406 Lake Howell Road, Maitland, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-26 | 406 Lake Howell Road, Maitland, FL 32751 | No data |
| CHANGE OF MAILING ADDRESS | 2013-01-26 | 406 Lake Howell Road, Maitland, FL 32751 | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2021-08-09 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-10 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-01-26 |
| ANNUAL REPORT | 2012-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
