| Entity Name: | DENNY RAGSDALE, MD, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Jul 1998 (26 years ago) |
| Document Number: | P98000066104 |
| FEI/EIN Number | 593523338 |
| Address: | 222 ORLANDO BOULEVARD, INDIALANTIC, FL, 32903, US |
| Mail Address: | 222 ORLANDO BOULEVARD, INDIALANTIC, FL, 32903, US |
| ZIP code: | 32903 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205982089 | 2007-01-26 | 2015-12-07 | 222 ORLANDO BLVD, INDIALANTIC, FL, 329033421, US | 222 ORLANDO BLVD, INDIALANTIC, FL, 329033421, US | |||||||||||||||||||||
|
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| Phone | +1 321-432-9564 |
| Fax | 3217221764 |
| Phone | +1 321-432-9565 |
Authorized person
| Name | VERNICE D RAGSDALE |
| Role | PRESIDENT |
| Phone | 3214329564 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME13755 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KAHN MICHAEL E | Agent | 482 NORTH HARBOR CITY BLVD, MELBOURNE, FL, 32935 |
| Name | Role | Address |
|---|---|---|
| RAGSDALE DENNY | Director | 222 ORLANDO BOULEVARD, INDIALANTIC, FL, 32903 |
| Name | Role | Address |
|---|---|---|
| Ragsdale Frances W | Vice President | 222 ORLANDO BOULEVARD, INDIALANTIC, FL, 32903 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
