| Entity Name: | KEVIN T. KELLY, M.D. PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Sep 2005 (19 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: | P05000132803 |
| FEI/EIN Number | 203544178 |
| Address: | 1397 MEDICAL PARK BLVD., STE 240, WELLINGTON, FL, 33414 |
| Mail Address: | 1397 MEDICAL PARK BLVD, STE 240, WELLINGTON, FL, 33414 |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538363742 | 2007-06-12 | 2020-08-22 | 1397 MEDICAL PARK BLVD, SUITE 240, WELLINGTON, FL, 33414, US | 1397 MEDICAL PARK BLVD, SUITE 240, WELLINGTON, FL, 33414, US | |||||||||||||||||
|
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| Phone | +1 561-784-3788 |
Authorized person
| Name | DR. KEVIN THOMAS KELLY |
| Role | CEO |
| Phone | 5616289969 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME0056260 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KELLY KEVIN T | Agent | 1397 MEDICAL PARK BLVD, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| KELLY KEVIN TDr. | President | 1397 MEDICAL PARK BLVD, STE 240, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| KELLY KEVIN TDr. | Treasurer | 1397 MEDICAL PARK BLVD, STE 240, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| KELLY LINDA S | Secretary | 1397 MEDICAL PARK BLVD., WELLINGTON, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-31 | 1397 MEDICAL PARK BLVD., STE 240, WELLINGTON, FL 33414 | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-31 | 1397 MEDICAL PARK BLVD., STE 240, WELLINGTON, FL 33414 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-01-31 | 1397 MEDICAL PARK BLVD, STE 240, WELLINGTON, FL 33414 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-01-19 | KELLY, KEVIN TPST | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-03-26 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-03-31 |
| ANNUAL REPORT | 2017-03-09 |
| ANNUAL REPORT | 2016-02-05 |
| ANNUAL REPORT | 2015-01-16 |
| ANNUAL REPORT | 2014-02-07 |
| ANNUAL REPORT | 2013-01-14 |
| ANNUAL REPORT | 2012-02-14 |
| ANNUAL REPORT | 2011-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
