| Entity Name: | DONALD W WHITAKER MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Feb 2010 (15 years ago) |
| Document Number: | P10000014910 |
| FEI/EIN Number | 271963149 |
| Address: | 924 MAR WALT DRIVE, FT WALTON BEACH, FL, 32547, US |
| Mail Address: | 924 MAR WALT DRIVE, FT WALTON BEACH, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568785277 | 2010-03-09 | 2014-07-22 | PO BOX 2617, FORT WALTON BEACH, FL, 325492617, US | 924 MAR WALT DR, FORT WALTON BEACH, FL, 325476706, US | |||||||||||||||||
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| Phone | +1 850-863-1000 |
Authorized person
| Name | DONALD W WHITAKER |
| Role | PRESIDENT |
| Phone | 8508556707 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME66730 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WHITAKER DONALD W | Agent | 924 MAR WALT DRIVE, FT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| WHITAKER DONALD W | President | 924 MAR WALT DRIVE, FT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| WHITAKER DONALD W | Secretary | 924 MAR WALT DRIVE, FT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-16 | 924 MAR WALT DRIVE, FT WALTON BEACH, FL 32547 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-08-18 | 924 MAR WALT DRIVE, FT WALTON BEACH, FL 32547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-03 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-03 |
| ANNUAL REPORT | 2021-01-06 |
| ANNUAL REPORT | 2020-01-10 |
| ANNUAL REPORT | 2019-01-07 |
| ANNUAL REPORT | 2018-01-04 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
