| Entity Name: | SANDRA LYNN PRICE MD, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 May 2008 (17 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P08000048047 |
| FEI/EIN Number | 300487270 |
| Address: | 628 S.E. 17th St., OCALA, FL, 34471, US |
| Mail Address: | 628 S.E. 17th St, OCALA, FL, 34471, US |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093008831 | 2011-05-26 | 2011-05-26 | 628 SE 17TH ST, OCALA, FL, 344714429, US | 628 SE 17TH ST, OCALA, FL, 344714429, US | |||||||||||||||||||||||||
|
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| Phone | +1 352-732-5151 |
| Fax | 3526907800 |
Authorized person
| Name | SANDRA LYNN PRICE |
| Role | PHYSICIAN |
| Phone | 3527325151 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | ME0016373 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PROVIDER TRANSACTION # |
| Number | 42091 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARNES Judy M | Agent | 628 S.E. 17th St., OCALA, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| PRICE SANDRA LYNN M | President | 628 S.E. 17th St., OCALA, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2016-03-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-08 | 628 S.E. 17th St., OCALA, FL 34471 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-08 | 628 S.E. 17th St., OCALA, FL 34471 | No data |
| CHANGE OF MAILING ADDRESS | 2016-03-08 | 628 S.E. 17th St., OCALA, FL 34471 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-03-08 | BARNES, Judy M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-01-07 |
| ANNUAL REPORT | 2018-06-04 |
| ANNUAL REPORT | 2017-01-19 |
| REINSTATEMENT | 2016-03-08 |
| ANNUAL REPORT | 2014-03-19 |
| ANNUAL REPORT | 2013-01-29 |
| ANNUAL REPORT | 2012-01-10 |
| ANNUAL REPORT | 2011-04-03 |
| ANNUAL REPORT | 2010-02-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
