| Entity Name: | ANCIENT CITY MIDWIVES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Aug 2008 (17 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P08000075560 |
| FEI/EIN Number | 263156692 |
| Address: | 1301 Plantation Island Dr., SUITE 105 B, ST AUGUSTINE, FL, 32080, US |
| Mail Address: | 1301 Plantation Island Dr, 105 B, ST AUGUSTINE, FL, 32080, US |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720236383 | 2008-09-08 | 2012-05-14 | PO BOX 3123, ST AUGUSTINE, FL, 320853123, US | 1301 PLANTATION ISLAND DR S, STE 105-B, ST AUGUSTINE, FL, 320803108, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 904-824-4990 |
| Fax | 9048242226 |
| Phone | +1 904-826-1007 |
| Fax | 9048261073 |
Authorized person
| Name | MICHELE ROGERO |
| Role | PRESIDENT |
| Phone | 9048261007 |
Taxonomy
| Taxonomy Code | 367A00000X - Advanced Practice Midwife |
| License Number | ARNP 1634442 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 98118 |
| State | FL |
| Issuer | MEDICAID |
| Number | 000664500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROGERO MICHELE G | Agent | 2421 KACIE LANE, ST AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| ROGERO MICHELE G | President | 2421 KACIE LANE, ST AUGUSTINE, FL, 32084 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-24 | 1301 Plantation Island Dr., SUITE 105 B, ST AUGUSTINE, FL 32080 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-24 | 1301 Plantation Island Dr., SUITE 105 B, ST AUGUSTINE, FL 32080 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-05-01 |
| ANNUAL REPORT | 2013-04-24 |
| ANNUAL REPORT | 2012-04-20 |
| ANNUAL REPORT | 2011-01-29 |
| ANNUAL REPORT | 2010-04-21 |
| ANNUAL REPORT | 2009-04-27 |
| Domestic Profit | 2008-08-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
