| Entity Name: | YOLAINE MARIE CHAMBLIN,MD ,PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 26 Apr 2006 (19 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P06000059457 |
| FEI/EIN Number | 204773814 |
| Address: | 8910 MIRAMAR PARKWAY, SUITE 117, MIRAMAR, FL, 33025 |
| Mail Address: | 14961 E. FALCON'S LEA CIRCLE, DAVIA, FL, 33331 |
| ZIP code: | 33025 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568497352 | 2006-07-11 | 2011-07-13 | 6785 BROOKLINE DR, HIALEAH, FL, 330152441, US | 8910 MIRAMAR PKWY, SUITE 110, MIRAMAR, FL, 330254100, US | |||||||||||||||||||||||
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| Phone | +1 305-200-1552 |
| Fax | 3052001552 |
| Phone | +1 954-442-6988 |
| Fax | 9544426202 |
Authorized person
| Name | DR. YOLAINE MARIE CHAMBLIN |
| Role | PHYSICIAN |
| Phone | 3052001552 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME 88893 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHAMBLIN YOLAINE M | Agent | 14961 E. FALCON'S LEA CIRCLE, DAVIE, FL, 33331 |
| Name | Role | Address |
|---|---|---|
| CHAMBLIN YOLAINE M | President | 14961 E FALCON'S LEA CIRCLE, DAVIE, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REVOCATION OF VOLUNTARY DISSOLUT | 2012-06-18 | No data | No data |
| VOLUNTARY DISSOLUTION | 2012-04-20 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-29 | 14961 E. FALCON'S LEA CIRCLE, DAVIE, FL 33331 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-29 | 8910 MIRAMAR PARKWAY, SUITE 117, MIRAMAR, FL 33025 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-29 | 8910 MIRAMAR PARKWAY, SUITE 117, MIRAMAR, FL 33025 | No data |
| CANCEL ADM DISS/REV | 2010-04-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2008-11-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12000269541 | TERMINATED | 1000000262219 | BROWARD | 2012-04-02 | 2022-04-11 | $ 2,267.30 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096 |
| Name | Date |
|---|---|
| Dom/For AR | 2012-06-18 |
| Revocation of Dissolution | 2012-06-18 |
| VOLUNTARY DISSOLUTION | 2012-04-20 |
| ANNUAL REPORT | 2011-04-29 |
| CORAPREIWP | 2010-04-01 |
| REINSTATEMENT | 2008-11-24 |
| ANNUAL REPORT | 2007-07-18 |
| Domestic Profit | 2006-04-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
