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WYNDAL K. BLANKENSHIP, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: WYNDAL K. BLANKENSHIP, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 01 Feb 1999 (27 years ago)
Date of dissolution: 22 Sep 2023 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2023 (2 years ago)
Document Number: P99000010591
FEI/EIN Number 593567435
Address: 115 Baywind Dr, Niceville, FL, 32578, US
Mail Address: 115 Baywind Dr, Niceville, FL, 32578, US
ZIP code: 32578
City: Niceville
County: Okaloosa
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BLANKENSHIP WYNDAL K Agent 115 Baywind Dr, Niceville, FL, 32578
BLANKENSHIP WYNDAL K Director 120 JOHN SIMS PKWY STE A, VALPARAISO, FL, 32580

National Provider Identifier

NPI Number:
1316930571

Authorized Person:

Name:
DEBBIE J ANDERSON
Role:
INS MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8507290331

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -
CHANGE OF PRINCIPAL ADDRESS 2022-04-28 115 Baywind Dr, Niceville, FL 32578 -
CHANGE OF MAILING ADDRESS 2022-04-28 115 Baywind Dr, Niceville, FL 32578 -
REGISTERED AGENT ADDRESS CHANGED 2022-04-28 115 Baywind Dr, Niceville, FL 32578 -
REGISTERED AGENT NAME CHANGED 2020-04-06 BLANKENSHIP, WYNDAL K -
REINSTATEMENT 2020-04-06 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 - -

Documents

Name Date
ANNUAL REPORT 2022-04-28
ANNUAL REPORT 2021-03-24
REINSTATEMENT 2020-04-06
ANNUAL REPORT 2017-01-13
ANNUAL REPORT 2016-01-26
ANNUAL REPORT 2015-01-13
ANNUAL REPORT 2014-01-12
ANNUAL REPORT 2013-01-18
ANNUAL REPORT 2012-01-10
ANNUAL REPORT 2011-01-07

Paycheck Protection Program

Jobs Reported:
7
Initial Approval Amount:
$26,677.5
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$26,677.5
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$26,997.63
Servicing Lender:
Synovus Bank
Use of Proceeds:
Payroll: $26,677.5

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Date of last update: 01 Aug 2025

Sources: Florida Department of State