| Entity Name: | VICTORINA'S DIABETES ENDOCRINOLOGY AND METABOLISM, INC., |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 25 Mar 2016 (9 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P16000028065 |
| FEI/EIN Number | 81-2060897 |
| Address: | 325 Clyde Morris Blvd, ORMOND BEACH, FL, 32174, US |
| Mail Address: | P.O. BOX 730513, ORMOND BEACH, FL, 32173, US |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972050235 | 2016-09-04 | 2017-04-06 | PO BOX 350812, PALM COAST, FL, 321350812, US | 4879 PALM COAST PKWY NW, UNIT # 2, PALM COAST, FL, 321373672, US | |||||||||||||||||||
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| Phone | +1 386-225-4462 |
| Fax | 3862254465 |
Authorized person
| Name | DR. WILFRED MARCO VICTORINA |
| Role | PRESIDENT |
| Phone | 8594961803 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME126126 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VICTORINA WILFRED M | Agent | 352 Clyde Morris Blvd, Ormond Beach, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| VICTORINA WILFRED M | President | P.O. BOX 730513, ORMOND BEACH, FL, 32173 |
| Name | Role | Address |
|---|---|---|
| VICTORINA WILFRED M | Secretary | P.O. BOX 730513, ORMOND BEACH, FL, 32173 |
| Name | Role | Address |
|---|---|---|
| VICTORINA WILFRED M | Treasurer | P.O. BOX 730513, ORMOND BEACH, FL, 32173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-09-21 | 325 Clyde Morris Blvd, Suite 430, ORMOND BEACH, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2018-09-21 | 325 Clyde Morris Blvd, Suite 430, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-09-21 | 352 Clyde Morris Blvd, Suite 430, Ormond Beach, FL 32174 | No data |
| AMENDMENT | 2017-02-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-09-21 |
| ANNUAL REPORT | 2017-05-01 |
| Amendment | 2017-02-15 |
| Domestic Profit | 2016-03-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
