| Entity Name: | R. MICHAEL TUCKER, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Oct 2013 (11 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: | P13000080644 |
| FEI/EIN Number | 46-3773410 |
| Address: | 60 WESTMINSTER, SUITE A, LEHIGH ACRES, FL, 33936 |
| Mail Address: | 2797 1st Street, FT. MYERS, FL, 33916, US |
| ZIP code: | 33936 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548697436 | 2013-10-09 | 2013-10-09 | 8851 BOARDROOM CIR, FORT MYERS, FL, 339194888, US | 60 WESTMINSTER ST N, SUITE A, LEHIGH ACRES, FL, 339366518, US | |||||||||||||||||||||||||||||
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| Phone | +1 239-481-7000 |
| Fax | 2394338999 |
| Phone | +1 239-368-1808 |
| Fax | 2394818150 |
Authorized person
| Name | RALPH MICHAEL TUCKER |
| Role | OWNER |
| Phone | 2394817000 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME51024 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME51024 |
| State | FL |
| Name | Role |
|---|---|
| TAX & FINANCIAL STRATEGISTS, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| TUCKER R. MICHAEL | President | 2797 1st Street, FT. MYERS, FL, 33916 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-04 | 60 WESTMINSTER, SUITE A, LEHIGH ACRES, FL 33936 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-03-14 |
| ANNUAL REPORT | 2014-01-14 |
| Domestic Profit | 2013-10-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
