| Entity Name: | RESTORE PLASTIC SURGERY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 17 Feb 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 14 Oct 2019 (5 years ago) |
| Document Number: | P15000016030 |
| FEI/EIN Number | 47-3341730 |
| Address: | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 |
| Mail Address: | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 |
| ZIP code: | 32563 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386030443 | 2015-04-15 | 2019-07-31 | 543 FONTAINE ST, PENSACOLA, FL, 325032058, US | 600 E GOVERNMENT ST, PENSACOLA, FL, 325026136, US | |||||||||||||||||||||
|
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| Phone | +1 202-431-6784 |
| Phone | +1 850-500-7527 |
| Fax | 8508554030 |
Authorized person
| Name | DR. BENJAMIN JACOB BROWN |
| Role | OWNER |
| Phone | 8505007527 |
Taxonomy
| Taxonomy Code | 2086S0122X - Plastic and Reconstructive Surgery Physician |
| License Number | ME 122557 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RUSHING, ROBERT S | Agent | 151 West Main Street, Suite 200, Pensacola, FL 32502 |
| Name | Role | Address |
|---|---|---|
| BROWN, BENJAMIN J, M.D. | Director | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 |
| Name | Role | Address |
|---|---|---|
| BROWN, BENJAMIN J, M.D. | President | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 |
| Name | Role | Address |
|---|---|---|
| BROWN, BENJAMIN J, M.D. | Secretary | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 |
| Name | Role | Address |
|---|---|---|
| BROWN, BENJAMIN J, M.D. | Treasurer | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-04 | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-04 | 1645 Nantahala Beach Rd, Gulf Breeze, FL 32563 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-30 | 151 West Main Street, Suite 200, Pensacola, FL 32502 | No data |
| REINSTATEMENT | 2019-10-14 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2017-11-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| Reg. Agent Resignation | 2023-12-19 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-30 |
| REINSTATEMENT | 2019-10-14 |
| ANNUAL REPORT | 2018-03-05 |
| REINSTATEMENT | 2017-11-30 |
| ANNUAL REPORT | 2016-07-19 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
