| Entity Name: | DANIEL R PRENTICE PA-C, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Sep 2011 (13 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P11000078917 |
| FEI/EIN Number | 453215790 |
| Address: | 10270 BERNARDA CT, SPRING HILL, FL, 34608-1200, US |
| Mail Address: | 10270 BERNARDA CT, SPRING HILL, FL, 34608-1200, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811273790 | 2011-10-24 | 2011-10-24 | 10270 BERNARDA CT, SPRING HILL, FL, 346081200, US | 10270 BERNARDA CT, SPRING HILL, FL, 346081200, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 352-597-4686 |
| Fax | 3525974686 |
Authorized person
| Name | MR. DANIEL R PRENTICE |
| Role | OWNER |
| Phone | 3525974686 |
Taxonomy
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PRENTICE DANIEL R | Agent | 10270 BERNARDA CT, SPRING HILL, FL, 346081200 |
| Name | Role | Address |
|---|---|---|
| PRENTICE DANIEL P | President | 10270 BERNARDA CT, SPRING HILL, FL, 346081200 |
| Name | Role | Address |
|---|---|---|
| PRENTICE LINDA | Director | 10270 BERNARDA CT, SPRING HILL, FL, 346081200 |
| Name | Role | Address |
|---|---|---|
| PRENTICE LAUREN | Chairman | 10270 BERNARDA CT, SPRING HILL, FL, 346081200 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-09 | 10270 BERNARDA CT, SPRING HILL, FL 34608-1200 | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-09 | 10270 BERNARDA CT, SPRING HILL, FL 34608-1200 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-02-09 |
| Domestic Profit | 2011-09-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
