| Entity Name: | PINE ISLAND DIABETIC SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Nov 1998 (26 years ago) |
| Date of dissolution: | 16 Mar 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 16 Mar 2015 (10 years ago) |
| Document Number: | P98000095749 |
| FEI/EIN Number | 650798094 |
| Address: | 1400 COLONIAL BLVD., 84, FORT MYERS, FL, 33907 |
| Mail Address: | PO Box 60171, FORT MYERS, FL, 33906, US |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205949625 | 2006-08-17 | 2008-08-07 | 1400 COLONIAL BLVD, SUITE 84, FORT MYERS, FL, 339071055, US | 1400 COLONIAL BLVD, SUITE 84, FORT MYERS, FL, 339071055, US | |||||||||||||||||||||
|
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| Phone | +1 239-931-3131 |
| Fax | 2399313133 |
Authorized person
| Name | MRS. PATRICIA ANN COBEY |
| Role | PRESIDENT |
| Phone | 2399313131 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031381500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COBEY PATRICIA | Agent | 14083 BENTLY CIRCLE, FORT MYERS, FL, 33912 |
| Name | Role | Address |
|---|---|---|
| COBEY PATRICIA | President | 14083 BENTLY CIRCLE, FORT MYERS, FL, 33912 |
| Name | Role | Address |
|---|---|---|
| COBEY JAMES | Vice President | 14083 BENTLY CIRCLE, FORT MYERS, FL, 33912 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2015-03-16 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-07 | 1400 COLONIAL BLVD., 84, FORT MYERS, FL 33907 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-02-17 | 14083 BENTLY CIRCLE, FORT MYERS, FL 33912 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-02-13 | 1400 COLONIAL BLVD., 84, FORT MYERS, FL 33907 | No data |
| Name | Date |
|---|---|
| CORAPVDWN | 2015-03-16 |
| ANNUAL REPORT | 2015-03-07 |
| ANNUAL REPORT | 2014-04-17 |
| ANNUAL REPORT | 2013-04-18 |
| ANNUAL REPORT | 2012-04-25 |
| ANNUAL REPORT | 2011-04-26 |
| ANNUAL REPORT | 2010-04-23 |
| ANNUAL REPORT | 2009-04-21 |
| ANNUAL REPORT | 2008-04-09 |
| ANNUAL REPORT | 2007-02-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
