| Entity Name: | MULBERRY PHYSICIAN ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Sep 2006 (18 years ago) |
| Date of dissolution: | 01 Sep 2018 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 01 Sep 2018 (6 years ago) |
| Document Number: | P06000116588 |
| FEI/EIN Number | 205516386 |
| Address: | 3320 Cypress Grove Drive, Eustis, FL, 32736, US |
| Mail Address: | C/O CARMELITA EBURUCHE MD, 2010 ELMSTEAD LANE, GROVETOWN, GA, 30813, US |
| ZIP code: | 32736 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801957881 | 2006-12-13 | 2011-09-23 | 918 ROLLING ACRES RD, SUITE #8, LADY LAKE, FL, 321595027, US | 918 ROLLING ACRES RD, SUITE #8, LADY LAKE, FL, 321595027, US | |||||||||||||||||||||
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| Phone | +1 352-750-6358 |
| Fax | 3527506329 |
Authorized person
| Name | DR. CARMELITA CHINYERE EBURUCHE |
| Role | OWNER |
| Phone | 3527506358 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | P00415689 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EBURUCHE CARMELITA C | Agent | 3320 CYPRESS GROVE DRIVE, EUSTIS, FL, 32736 |
| Name | Role | Address |
|---|---|---|
| EBURUCHE CARMELITA C | President | 3320 Cypress Grove Drive, Eustis, FL, 32736 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-09-01 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-08-26 | 3320 Cypress Grove Drive, Eustis, FL 32736 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-17 | 3320 Cypress Grove Drive, Eustis, FL 32736 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-04-22 | EBURUCHE, CARMELITA C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-17 | 3320 CYPRESS GROVE DRIVE, EUSTIS, FL 32736 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-05-04 |
| ANNUAL REPORT | 2016-04-17 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-03-06 |
| ANNUAL REPORT | 2012-04-12 |
| ANNUAL REPORT | 2011-04-29 |
| ANNUAL REPORT | 2010-04-09 |
| ANNUAL REPORT | 2009-03-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
