| Entity Name: | EUGENE H USOW DO PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 08 May 2006 (19 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P06000064837 |
| FEI/EIN Number | 204845116 |
| Address: | 709 SEBASTIAN BLVD, SUITE F, SEBASTIAN, FL, 32958, US |
| Mail Address: | 709 SEBASTIAN BLVD., SUITE F, SEBASTIAN, FL, 32958, US |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235289778 | 2007-01-10 | 2008-09-09 | 709 SEBASTIAN BLVD, SUITE F, SEBASTIAN, FL, 329588704, US | 709 SEBASTIAN BLVD, SUITE F, SEBASTIAN, FL, 329588704, US | |||||||||||||||||||||||
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| Phone | +1 772-228-9511 |
Authorized person
| Name | EUGENE USOW |
| Role | PRESIDENT |
| Phone | 7722289511 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS9612 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2742519 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| USOW EUGENE H | Agent | 709 SEBASTIAN BLVD, SEBASTIAN, FL, 32958 |
| Name | Role | Address |
|---|---|---|
| USOW EUGENE H | Director | 709-F SEBASTIAN BLVD., SEBASTIAN, FL, 32958 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-07 | 709 SEBASTIAN BLVD, SUITE F, SEBASTIAN, FL 32958 | No data |
| CHANGE OF MAILING ADDRESS | 2007-01-07 | 709 SEBASTIAN BLVD, SUITE F, SEBASTIAN, FL 32958 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-01-07 | USOW, EUGENE HDO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-01-07 | 709 SEBASTIAN BLVD, SUITE F, SEBASTIAN, FL 32958 | No data |
| AMENDMENT AND NAME CHANGE | 2006-07-05 | EUGENE H USOW DO PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-03-13 |
| ANNUAL REPORT | 2009-01-25 |
| ANNUAL REPORT | 2008-01-09 |
| ANNUAL REPORT | 2007-01-07 |
| Amendment and Name Change | 2006-07-05 |
| Domestic Profit | 2006-05-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
