| Entity Name: | ZENOVIA FULTON, DMD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Mar 2010 (15 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | P10000023271 |
| FEI/EIN Number | 451664901 |
| Address: | 6476 FT CAROLINE ROAD, JACKSONVILLE, FL, 32277, US |
| Mail Address: | 6476 FT CAROLINE ROAD, JACKSONVILLE, FL, 32277, US |
| ZIP code: | 32277 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073903860 | 2015-01-31 | 2015-01-31 | 6476 FORT CAROLINE RD, JACKSONVILLE, FL, 322772042, US | 6476 FORT CAROLINE RD, JACKSONVILLE, FL, 322772042, US | |||||||||||||||||||||||||
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| Phone | +1 904-743-0900 |
| Fax | 9047434645 |
Authorized person
| Name | DR. ZENOVIA FULTON |
| Role | OWNER |
| Phone | 9047430900 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN13608 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003826000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FULTON ZENOVIA | Agent | 6476 FT. CAROLINE ROAD, JACKSONVILLE, FL, 32277 |
| Name | Role | Address |
|---|---|---|
| FULTON ZENOVIA | President | 6476 FT CAROLINE RD, JACKSONVILLE, FL, 32277 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2025-01-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-07-30 |
| ANNUAL REPORT | 2021-07-31 |
| ANNUAL REPORT | 2020-05-05 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-08-16 |
| ANNUAL REPORT | 2017-07-09 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-30 |
| ANNUAL REPORT | 2014-04-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
