MILLER VASCULAR PA

Company Details

Entity Name:	MILLER VASCULAR PA
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Inactive
Date Filed:	24 May 2007 (18 years ago)
Date of dissolution:	23 Sep 2016 (8 years ago)
Last Event:	ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed:	23 Sep 2016 (8 years ago)
Document Number:	P07000062233
FEI/EIN Number	260233684
Address:	11 RACETRACK ROAD, NE, E 4, FT. WALTON BEACH, FL, 32547, US
Mail Address:	4607 CHANAN DR, CRESTVIEW, FL, 32539, US
ZIP code:	32547
County:	Okaloosa
Place of Formation:	FLORIDA

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1427328343

2012-01-09

4607 CHANAN DR, CRESTVIEW, FL, 325394341, US

11 RACETRACK RD NE, SUITE E4, FORT WALTON BEACH, FL, 325471882, US

Contacts

Authorized person

Taxonomy

Taxonomy Code	261QA1903X - Ambulatory Surgical Clinic/Center
License Number	ME98427
State	FL
Is Primary	Yes

Name	Role	Address
MILLER MICHAEL L	Agent	4607 CHANAN DR, CRESTVIEW, FL, 32539

Name	Role	Address
MILLER MICHAEL L	President	4607 CHANAN DR, CRESTVIEW, FL, 32539

Name	Role	Address
MILLER PATRICIA N	Vice President	4607 CHANAN DR, CRESTVIEW, FL, 32539

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G10000066589	EMERALD COAST VEIN CENTER	EXPIRED	2010-07-19	2015-12-31	No data	11 RACETRACK RD. NE, SUITE E4, FT. WALTON BEACH, FL, 32547
G08183900213	NORTHWEST FLORIDA VEIN TREATMENT CENTER	EXPIRED	2008-07-01	2013-12-31	No data	1032 MAR WALT DR., FORT WALTON BEACH, FL, 32547

Event Type	Filed Date	Value	Description
ADMIN DISSOLUTION FOR ANNUAL REPORT	2016-09-23	No data	No data
CHANGE OF PRINCIPAL ADDRESS	2011-01-06	11 RACETRACK ROAD, NE, E 4, FT. WALTON BEACH, FL 32547	No data

Date of last update: 01 Feb 2025