| Entity Name: | SOUTHEASTERN MED-SERVICE SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 29 Sep 1997 (27 years ago) |
| Date of dissolution: | 14 Sep 2007 (17 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 14 Sep 2007 (17 years ago) |
| Document Number: | P97000084262 |
| FEI/EIN Number | 65-0780116 |
| Address: | 4390 SW 74TH AVE, MIAMI, FL 33155 |
| Mail Address: | 4390 SW 74TH AVE, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447210091 | 2006-03-27 | 2020-08-22 | 4390 SW 74TH AVE, MIAMI, FL, 331554406, US | 4390 SW 74TH AVE, MIAMI, FL, 331554406, US | |||||||||||||||||||
|
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| Phone | +1 305-264-2023 |
| Fax | 3052643535 |
Authorized person
| Name | MR. ROBERT F. FOUNTAIN |
| Role | PRESIDENT |
| Phone | 3052642023 |
Taxonomy
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 327 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FOUNTAIN, ROBERT F | Agent | 11000 NE 9 COURT, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| FOUNTAIN, ROBERT F | President | 11000 NE 9TH CT, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| SELPH, JIMMIE J | Chief Executive Officer | 1715 GREEN ST, WARNER ROBINS, GA 31088 |
| Name | Role | Address |
|---|---|---|
| SIMPSON, TRACY S | Secretary | 312 N. DAVIS DRIVE, WARNER ROBINS, GA 31093 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-12-10 | 4390 SW 74TH AVE, MIAMI, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2004-12-10 | 4390 SW 74TH AVE, MIAMI, FL 33155 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2006-01-12 |
| ANNUAL REPORT | 2005-01-25 |
| ANNUAL REPORT | 2004-12-10 |
| ANNUAL REPORT | 2004-07-23 |
| ANNUAL REPORT | 2003-02-11 |
| ANNUAL REPORT | 2002-01-11 |
| ANNUAL REPORT | 2001-04-02 |
| ANNUAL REPORT | 2000-03-21 |
| ANNUAL REPORT | 1999-05-06 |
| ANNUAL REPORT | 1998-03-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
