| Entity Name: | ORMOND MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Dec 1992 (32 years ago) |
| Document Number: | P92000013560 |
| FEI/EIN Number | 593166150 |
| Address: | 545 W GRANADA BLVD., ORMOND BEACH, FL, 32174, US |
| Mail Address: | 545 W GRANADA BLVD., ORMOND BEACH, FL, 32174, US |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538268677 | 2006-09-22 | 2010-02-22 | 545 WEST GRANADA BLVD, ORMOND BEACH, FL, 32174, US | 545 W GRANADA BLVD, ORMOND BEACH, FL, 321745103, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 386-672-6243 |
| Fax | 3866777463 |
Authorized person
| Name | MRS. MARIA A DAILY |
| Role | OFFICE MANAGER |
| Phone | 3866726243 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH2950 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6392 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS9094 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FRAZER ROBERT D | Agent | 2090 S NOVA RD, DAYTONA BEACH, FL, 32119 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ MICHAEL J | Director | 545 W GRANADA BLVD, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2017-12-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| NAME CHANGE AMENDMENT | 1999-10-07 | ORMOND MEDICAL CENTER, INC. | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
