| Entity Name: | PALM BEACH DERMATOLOGY INSTITUTE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 22 Apr 2009 (16 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P09000035919 |
| FEI/EIN Number | 26-4813736 |
| Address: | 1760 N CONGRESS AVE., 200, BOYNTON BEACH, FL 33426 |
| Mail Address: | 1760 N CONGRESS AVE., 200, BOYNTON BEACH, FL 33426 |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780814103 | 2009-07-20 | 2009-08-25 | 1760 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL, 334268214, US | 1760 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL, 334268214, US | |||||||||||||||||||
|
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| Phone | +1 561-733-0077 |
| Fax | 5617330020 |
Authorized person
| Name | DR. HAL BLAKE RIDGWAY |
| Role | PRES |
| Phone | 5619647500 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | ME54995 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RIDGWAY, HAL B | Agent | 1007 N.ATLANTIC DRIVE, LANTANA, FL 33462 |
| Name | Role | Address |
|---|---|---|
| RIDGWAY, HAL B | President | 1007 N.ATLANTIC DRIVE, LANTANA, FL 33462 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-05-01 | 1760 N CONGRESS AVE., 200, BOYNTON BEACH, FL 33426 | No data |
| CHANGE OF MAILING ADDRESS | 2010-05-01 | 1760 N CONGRESS AVE., 200, BOYNTON BEACH, FL 33426 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-03-30 |
| ANNUAL REPORT | 2010-05-01 |
| Domestic Profit | 2009-04-22 |
Date of last update: 24 Feb 2025
Sources: Florida Department of State
