| Entity Name: | FLAGEL PEDIATRIC & FAMILY MEDICINE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Jun 2010 (15 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P10000048154 |
| FEI/EIN Number | 272810084 |
| Address: | 2572 COMMERCE PARKWAY, NORTH PORT, FL, 34289, US |
| Mail Address: | 2572 COMMERCE PARKWAY, NORTH PORT, FL, 34289, US |
| ZIP code: | 34289 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790090538 | 2010-08-17 | 2017-03-28 | 2572 COMMERCE PARKWAY, NORTH PORT, FL, 34289, US | 2572 COMMERCE PARKWAY, NORTH PORT, FL, 34289, US | |||||||||||||||||||||||||||
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| Phone | +1 941-429-3545 |
| Fax | 9414293546 |
Authorized person
| Name | SUSAN D FLAGEL |
| Role | OWNER/OPERATOR |
| Phone | 9414293545 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME 107190 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | OS 10992 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WILSON MICHAEL M | Agent | 17801 MURDOCK CIRCLE, PORT CHARLOTTE, FL |
| Name | Role | Address |
|---|---|---|
| FLAGEL SUSAN D | Director | 2572 COMMERCE PARKWAY, NORTH PORT, FL, 34289 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000053494 | FLAGEL PEDIATRIC & FAMILY MEDICINE | EXPIRED | 2010-06-14 | 2015-12-31 | No data | 2560 N. TOLEDO BLADE BLVD., NORTH PORT, FL, 34289 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-05-01 | 2572 COMMERCE PARKWAY, NORTH PORT, FL 34289 | No data |
| CHANGE OF MAILING ADDRESS | 2016-05-01 | 2572 COMMERCE PARKWAY, NORTH PORT, FL 34289 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-02-13 |
| ANNUAL REPORT | 2014-03-21 |
| ANNUAL REPORT | 2013-06-25 |
| ANNUAL REPORT | 2012-02-22 |
| ANNUAL REPORT | 2011-07-08 |
| Domestic Profit | 2010-06-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
