| Entity Name: | CLINICAL TOXICOLOGY PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Jul 2016 (9 years ago) |
| Date of dissolution: | 23 Mar 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 23 Mar 2020 (5 years ago) |
| Document Number: | P16000056772 |
| FEI/EIN Number | 81-3212205 |
| Address: | 451 Kodiac Ave SE, Palm Bay, FL, 32909, US |
| Mail Address: | 451 Kodiac Ave SE, Palm Bay, FL, 32909, US |
| ZIP code: | 32909 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154870657 | 2016-09-25 | 2016-09-25 | 10269 SW VILLAGE PKWY, 102, PORT SAINT LUCIE, FL, 349872369, US | 10269 SW VILLAGE PKWY, 102, PORT SAINT LUCIE, FL, 349872369, US | |||||||||||||||||
|
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| Phone | +1 631-317-0988 |
Authorized person
| Name | DR. BRUCE TODD BURKS |
| Role | PRESIDENT |
| Phone | 6313170988 |
Taxonomy
| Taxonomy Code | 207ZP0102X - Anatomic Pathology & Clinical Pathology Physician |
| License Number | ME110112 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BURKS BRUCE T | Agent | 451 Kodiac Ave SE, Palm Bay, FL, 32909 |
| Name | Role | Address |
|---|---|---|
| BURKS BRUCE T | President | 451 Kodiac Ave SE, Palm Bay, FL, 32909 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-03-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-08-30 | 451 Kodiac Ave SE, Palm Bay, FL 32909 | No data |
| CHANGE OF MAILING ADDRESS | 2017-08-30 | 451 Kodiac Ave SE, Palm Bay, FL 32909 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-08-30 | 451 Kodiac Ave SE, Palm Bay, FL 32909 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-03-23 |
| ANNUAL REPORT | 2019-08-31 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-08-30 |
| Domestic Profit | 2016-07-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
