| Entity Name: | ELIAS R QUINTOS MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 19 Jun 2013 (12 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P13000052842 |
| FEI/EIN Number | 46-3003659 |
| Address: | 830 Monaco Dr, PORT CHARLOTTE, FL 33950 |
| Mail Address: | 830 MONACO DR, PUNTA GORDA, FL 33950 |
| ZIP code: | 33950 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326480831 | 2013-07-25 | 2013-07-25 | 4130 TAMIAMI TRL, SUITE 302, PORT CHARLOTTE, FL, 339529207, US | 4130 TAMIAMI TRL, SUITE 302, PORT CHARLOTTE, FL, 339529207, US | |||||||||||||||||||||||||
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| Phone | +1 941-206-0203 |
| Fax | 9416290503 |
Authorized person
| Name | DR. ELIAS R QUINTOS |
| Role | PRESIDENT |
| Phone | 9412060203 |
Taxonomy
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | ME55368 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 280347000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAMPBELL, J DAVID, EA | Agent | 45 TAMIAMI TRAIL, PUNTA GORDA, FL 33950 |
| Name | Role | Address |
|---|---|---|
| QUINTOS, ELIAS R, MD | President | 830 MONACO DR, PUNTA GORDA, FL 33950 |
| Name | Role | Address |
|---|---|---|
| QUINTOS, ELIAS R, MD | Treasurer | 830 MONACO DR, PUNTA GORDA, FL 33950 |
| Name | Role | Address |
|---|---|---|
| QUINTOS, AUGUSTA M | Vice President | 830 MONACO DR, PUNTA GORDA, FL 33950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-20 | 830 Monaco Dr, PORT CHARLOTTE, FL 33950 | No data |
| ARTICLES OF CORRECTION | 2013-07-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-03-20 |
| Articles of Correction | 2013-07-15 |
| Domestic Profit | 2013-06-19 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
