| Entity Name: | NICOLE R. KLEIN, DMD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Feb 2023 (2 years ago) |
| Document Number: | P23000011803 |
| FEI/EIN Number | 92-2611693 |
| Address: | 200 AVENUE K SE, SUITE NO. 1, WINTER HAVEN, FL 33880 |
| Mail Address: | 200 AVENUE K SE, SUITE NO. 1, WINTER HAVEN, FL 33880 |
| ZIP code: | 33880 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639867831 | 2023-04-26 | 2023-04-26 | 200 AVENUE K SE STE 1, WINTER HAVEN, FL, 338804003, US | 200 AVENUE K SE STE 1, WINTER HAVEN, FL, 338804003, US | |||||||||||||
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| Phone | +1 863-299-2192 |
Authorized person
| Name | NICOLE KLEIN |
| Role | OWNER/DENTIST |
| Phone | 7047960154 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KLEIN, NICOLE R, DR | Agent | 200 AVENUE K SE, SUITE NO. 1, WINTER HAVEN, FL 33880 |
| Name | Role | Address |
|---|---|---|
| KLEIN, NICOLE R, DR. | President | 200 AVENUE K SE - SUITE NO. 1, WINTER HAVEN, FL 33880 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-30 |
| ANNUAL REPORT | 2024-02-19 |
| Domestic Profit | 2023-02-07 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
