| Entity Name: | DCDW MEDICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Nov 2012 (12 years ago) |
| Date of dissolution: | 22 Feb 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 22 Feb 2023 (2 years ago) |
| Document Number: | P12000093284 |
| FEI/EIN Number | 900918387 |
| Address: | 16900 WEST FRONT BEACH ROAD, PANAMA CITY BEACH, FL, 32413, US |
| Mail Address: | 16900 WEST FRONT BEACH ROAD, PANAMA CITY BEACH, FL, 32413, US |
| ZIP code: | 32413 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164761029 | 2013-02-12 | 2022-09-01 | 16900 FRONT BEACH RD, PANAMA CITY BEACH, FL, 324132345, US | 16900 FRONT BEACH RD, PANAMA CITY BEACH, FL, 324132345, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-234-1898 |
| Fax | 8502347670 |
Authorized person
| Name | MARLEN CELENIA MORITZ |
| Role | ADMINISTRATOR |
| Phone | 8502481898 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS0589 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | OS0589 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008171000 |
| State | FL |
| Issuer | FLORIDA BLUE |
| Number | 0043L |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DRAPER DEWITT A | Agent | 16900 West Front Beach Road, Panama City Beach, FL, 32413 |
| Name | Role | Address |
|---|---|---|
| DRAPER DEWITT A | President | 16900 WEST FRONT BEACH ROAD, PANAMA CITY BEACH, FL, 32413 |
| Name | Role | Address |
|---|---|---|
| DRAPER DEWITT A | Chief Financial Officer | 16900 WEST FRONT BEACH ROAD, PANAMA CITY BEACH, FL, 32413 |
| Name | Role | Address |
|---|---|---|
| MORITZ MARLEN C | Vice President | 16900 WEST FRONT BEACH RD., PANAMA CITY BEACH, FL, 32413 |
| Name | Role | Address |
|---|---|---|
| MORITZ MARLEN C | Director | 16900 WEST FRONT BEACH RD., PANAMA CITY BEACH, FL, 32413 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000012612 | GULF VIEW MEDICAL | EXPIRED | 2013-02-05 | 2018-12-31 | No data | 16900 FRONT BEACH ROAD, PANAMA CITY BEACH, FL, 32413 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-02-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-10-08 | 16900 West Front Beach Road, Panama City Beach, FL 32413 | No data |
| AMENDMENT AND NAME CHANGE | 2021-10-08 | DCDW MEDICAL SERVICES, INC. | No data |
| REGISTERED AGENT NAME CHANGED | 2021-10-08 | DRAPER, DEWITT A. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-23 | 16900 WEST FRONT BEACH ROAD, PANAMA CITY BEACH, FL 32413 | No data |
| REINSTATEMENT | 2014-03-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-03-23 | 16900 WEST FRONT BEACH ROAD, PANAMA CITY BEACH, FL 32413 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-02-22 |
| ANNUAL REPORT | 2022-03-29 |
| Amendment and Name Change | 2021-10-08 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
