| Entity Name: | BUNNELL MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 25 Oct 2004 (20 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P04000146783 |
| FEI/EIN Number | 201820435 |
| Address: | 700 E MOODY BLVD., BUNNELL, FL, 32110, US |
| Mail Address: | P O BOX 727, BUNNELL, FL, 32110, US |
| ZIP code: | 32110 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720175649 | 2006-10-10 | 2008-06-20 | PO BOX 727, BUNNELL, FL, 321100727, US | 700 E. MOODY BLVD, BUNNELL, FL, 32110, US | |||||||||||||||||||||
|
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| Phone | +1 386-437-2481 |
| Fax | 3864372024 |
| Fax | 3864372404 |
Authorized person
| Name | MRS. GEORGIA CANAKARIS |
| Role | OFFICE ADMINISTRATOR |
| Phone | 3864372481 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 4541 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LUCAS SYLVESTER | Agent | 700 MOODY BLVD, BUNNELL, FL, 32110 |
| Name | Role | Address |
|---|---|---|
| LUCAS YOLANDA D | President | 700 E MOODY BLVD, BUNNELL, FL, 32110 |
| Name | Role | Address |
|---|---|---|
| LUCAS YOLANDA D | Director | 700 E MOODY BLVD, BUNNELL, FL, 32110 |
| Name | Role | Address |
|---|---|---|
| BANDELE OREBANWO D | Vice President | 700 E MOODY BLVD, BUNNELL, FL, 32110 |
| Name | Role | Address |
|---|---|---|
| LUCAS SYLVESTER | Treasurer | 700 E MOODY BLVD, BUNNELL, FL, 32110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-06-08 | 700 MOODY BLVD, BUNNELL, FL 32110 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-06-08 | LUCAS, SYLVESTER | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-10-01 | 700 E MOODY BLVD., BUNNELL, FL 32110 | No data |
| CANCEL ADM DISS/REV | 2008-10-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2007-04-28 | 700 E MOODY BLVD., BUNNELL, FL 32110 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-02-28 |
| ANNUAL REPORT | 2010-01-20 |
| ANNUAL REPORT | 2009-06-08 |
| REINSTATEMENT | 2008-10-01 |
| ANNUAL REPORT | 2007-04-28 |
| ANNUAL REPORT | 2006-05-01 |
| ANNUAL REPORT | 2005-05-04 |
| Domestic Profit | 2004-10-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
