| Entity Name: | COLEEN L. DOOLEY ARNP PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Feb 2006 (19 years ago) |
| Date of dissolution: | 08 Apr 2013 (12 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 08 Apr 2013 (12 years ago) |
| Document Number: | P06000022824 |
| FEI/EIN Number | 770719986 |
| Address: | 2409 N. ROOSEVELT BLVD., 6, KEY WEST, FL, 33040 |
| Mail Address: | P. O. BOX 420346, SUMMERLAND KEY, FL, 33042 |
| ZIP code: | 33040 |
| County: | Monroe |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659496958 | 2007-03-19 | 2008-10-23 | PO BOX 420346, SUMMERLAND KEY, FL, 330420346, US | 2409 N ROOSEVELT BLVD, SUITE 6, KEY WEST, FL, 330403837, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 305-745-8215 |
Authorized person
| Name | COLEEN L DOOLEY |
| Role | ARNP |
| Phone | 3057458215 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | ARNP624842 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | Y3409 |
| State | FL |
| Issuer | NPI TYPE 1 |
| Number | 1972660082 |
| State | FL |
| Issuer | MEDICAID |
| Number | 034293900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DOOLEY COLEEN L | Agent | 2409 N. ROOSEVELT BLVD., KEY WEST, FL, 33040 |
| Name | Role | Address |
|---|---|---|
| DOOLEY COLEEN L | ARNP | PO BOX 420346, SUMMERLAND KEY, FL, 33042 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-08 | No data | No data |
| NAME CHANGE AMENDMENT | 2008-10-01 | COLEEN L. DOOLEY ARNP PA | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-09 | 2409 N. ROOSEVELT BLVD., 6, KEY WEST, FL 33040 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-01-09 | 2409 N. ROOSEVELT BLVD., 6, KEY WEST, FL 33040 | No data |
| CHANGE OF MAILING ADDRESS | 2007-07-10 | 2409 N. ROOSEVELT BLVD., 6, KEY WEST, FL 33040 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-07-10 | DOOLEY, COLEEN L | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-08 |
| ANNUAL REPORT | 2012-04-02 |
| ANNUAL REPORT | 2011-04-03 |
| ANNUAL REPORT | 2010-04-30 |
| FEI# | 2010-04-22 |
| ANNUAL REPORT | 2009-04-06 |
| Name Change | 2008-10-01 |
| ANNUAL REPORT | 2008-01-09 |
| ANNUAL REPORT | 2007-07-10 |
| Domestic Profit | 2006-02-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
