| Entity Name: | PALM HARBOR DENTAL ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Nov 2004 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 22 Apr 2024 (10 months ago) |
| Document Number: | P04000151224 |
| FEI/EIN Number | 510522779 |
| Address: | 34669 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684 |
| Mail Address: | 34669 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684 |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285758839 | 2007-03-19 | 2017-04-25 | 34669 US HWY 19 N, PALM HARBOR, FL, 34684, US | 34669 US HWY 19 N, PALM HARBOR, FL, 34684, US | |||||||||||||||||||||||||||
|
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| Phone | +1 727-986-9144 |
| Fax | 7277869155 |
Authorized person
| Name | SIAMAK RAFIEIAN |
| Role | OWNER DENTIST |
| Phone | 7277869144 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN13918 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN3904 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RAFIEIAN SIAMAK | Agent | 34669 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| RAFIEIAN SIAMAK | President | 34669 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| RAFIEIAN SIAMAK | Director | 34669 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-04-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-06-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REINSTATEMENT | 2017-11-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-11-27 | RAFIEIAN, SIAMAK | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-04-22 |
| REINSTATEMENT | 2022-06-28 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-04-11 |
| REINSTATEMENT | 2017-11-27 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-03-24 |
| ANNUAL REPORT | 2014-04-28 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
