| Entity Name: | PLANTATION MEDICAL CARE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Feb 2018 (7 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: | P18000013975 |
| Address: | 9030 W FORT ISLAND TRAIL 11B, CRYSTAL RIVER, FL, 34429 |
| Mail Address: | PO BOX 1120, CRYSTAL RIVER, FL, 34423, US |
| ZIP code: | 34429 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497255814 | 2018-02-13 | 2018-06-21 | 9030 W FORT ISLAND TRL STE 11B, CRYSTAL RIVER, FL, 344292415, US | 9030 W FORT ISLAND TRL STE 11B, CRYSTAL RIVER, FL, 34429, US | |||||||||||||||||||||||||||
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| Phone | +1 352-651-5127 |
| Fax | 3526515129 |
Authorized person
| Name | ADRIANNE ASHMORE HESS |
| Role | OFFICE MANAGER |
| Phone | 3526515127 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| License Number | OS-0004310 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | OS4310 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CORBETT ROBERT M | Agent | 9030 W FORT ISLAND TRAIL 11B, CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| CORBETT ROBERT M | President | PO BOX 1120, CRYSTAL RIVER, FL, 34423 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000026375 | ROBERT M CORBETT DO | EXPIRED | 2018-02-22 | 2023-12-31 | No data | PO BOX 1120, CRYSTAL RIVER, FL, 34423 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2018-02-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
