| Entity Name: | NORTH NAPLES PEDIATRIC CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Jun 1997 (28 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 13 Jul 2022 (3 years ago) |
| Document Number: | P97000053197 |
| FEI/EIN Number | 593452584 |
| Address: | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL, 34110, US |
| Mail Address: | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL, 34110, US |
| ZIP code: | 34110 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922400340 | 2014-09-17 | 2014-09-17 | 9160 GALLERIA COURT, NAPLES, FL, 34109, US | 9160 GALLERIA COURT, NAPLES, FL, 34109, US | |||||||||||||||||||||||||
|
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| Phone | +1 239-514-8787 |
| Fax | 2395141965 |
Authorized person
| Name | DR. DINA A BADRA |
| Role | PHYSICAN |
| Phone | 2395148787 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME0065421 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 376548200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BADRA DINA Dr. | Agent | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL, 34110 |
| Name | Role | Address |
|---|---|---|
| BADRA DINA AMD | Director | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL, 34110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-09 | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL 34110 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-09 | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL 34110 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-09 | 15539 MONTEROSSO LANE UNIT 201, NAPLES, FL 34110 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2022-07-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-01-14 | BADRA, DINA, Dr. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-09 |
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-02-24 |
| REINSTATEMENT | 2022-07-13 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-02-25 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-01-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
