| Entity Name: | DENNIS D. DEWEY, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Oct 2009 (15 years ago) |
| Date of dissolution: | 26 Jan 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 26 Jan 2020 (5 years ago) |
| Document Number: | P09000086519 |
| FEI/EIN Number | 271211644 |
| Address: | 1895 KINGSLEY AVENUE, SUITE # 805, ORANGE PARK, FL, 32073 |
| Mail Address: | 1895 KINGSLEY AVENUE, SUITE # 805, ORANGE PARK, FL, 32073 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073840435 | 2009-11-05 | 2011-01-06 | PO BOX 17809, JACKSONVILLE, FL, 322457809, US | 1895 KINGSLEY AVE STE 805, ORANGE PARK, FL, 320734410, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-723-5665 |
| Fax | 9043380951 |
| Phone | +1 904-276-2220 |
| Fax | 9042762578 |
Authorized person
| Name | DENNIS D DEWEY |
| Role | PRESIDENT |
| Phone | 9042762220 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | ME47968 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 14167 |
| State | FL |
| Issuer | R.R. MEDICARE |
| Number | DP9414 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COLD KATHLEEN H | Agent | ONE INDEPENDENT DRIVE, SUITE 2301, JACKSONVILLE, FL, 32202 |
| Name | Role | Address |
|---|---|---|
| DEWEY DENNIS D | Director | SUITE 805, 1895 KINGSLEY AVENUE, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-01-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-11 | 1895 KINGSLEY AVENUE, SUITE # 805, ORANGE PARK, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-11 | 1895 KINGSLEY AVENUE, SUITE # 805, ORANGE PARK, FL 32073 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-01-26 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-02-22 |
| ANNUAL REPORT | 2016-01-17 |
| ANNUAL REPORT | 2015-01-20 |
| ANNUAL REPORT | 2014-03-01 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-02-16 |
| ANNUAL REPORT | 2011-01-06 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
