| Entity Name: | ISLAND PEDIATRICS OF ISLAMORADA, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Dec 2008 (16 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: | P08000107254 |
| FEI/EIN Number | 263875155 |
| Address: | 81599 OLD HIGHWAY, ISLAMORADA, FL, 33036 |
| Mail Address: | 81599 OLD HIGHWAY, ISLAMORADA, FL, 33036 |
| ZIP code: | 33036 |
| County: | Monroe |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124190764 | 2006-11-15 | 2009-03-18 | 81599 OLD HWY, ISLAMORADA, FL, 330363711, US | 81599 OLD HWY, ISLAMORADA, FL, 330363711, US | |||||||||||||||||
|
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| Phone | +1 305-664-3384 |
Authorized person
| Name | DR. KRISTI BENGTSON BAGNELL |
| Role | PRESIDENT |
| Phone | 3056643384 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME103085 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CATARINEAU JOE A | Agent | 91750 OVERSEAS HIGHWAY, TAVERNIER, FL, 33070 |
| Name | Role | Address |
|---|---|---|
| BAGNELL KRISTI | President | 81599 OLD HIGHWAY, ISLAMORADA, FL, 33039 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-30 | 81599 OLD HIGHWAY, ISLAMORADA, FL 33036 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-30 | 81599 OLD HIGHWAY, ISLAMORADA, FL 33036 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-01-13 |
| ANNUAL REPORT | 2009-04-30 |
| Domestic Profit | 2008-12-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
