| Entity Name: | MICHAEL K. RILEY, M.D. P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 12 Apr 1999 (26 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P99000034280 |
| FEI/EIN Number | 59-3571310 |
| Address: | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 |
| Mail Address: | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093742959 | 2006-06-27 | 2008-09-08 | 3304 SW 34TH CIR, SUITE 104, OCALA, FL, 344743358, US | 3304 SW 34TH CIR, SUITE 104, OCALA, FL, 344743358, US | |||||||||||||||||||||||||
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| Phone | +1 352-369-0080 |
| Fax | 3525472360 |
Authorized person
| Name | DONNIE MILLER |
| Role | OFFICE MANAGER |
| Phone | 3523690080 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME0068193 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 254551900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RILEY, MICHAEL K | Agent | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 |
| Name | Role | Address |
|---|---|---|
| RILEY, MICHAEL K | Director | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-07-06 | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 | No data |
| CHANGE OF MAILING ADDRESS | 2005-07-06 | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-07-06 | 2300 SE 17TH STREET, SUITE 500, OCALA, FL 34471 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-02-06 |
| ANNUAL REPORT | 2007-01-08 |
| ANNUAL REPORT | 2006-01-09 |
| ANNUAL REPORT | 2005-07-06 |
| ANNUAL REPORT | 2004-01-27 |
| ANNUAL REPORT | 2003-04-10 |
| ANNUAL REPORT | 2002-03-27 |
| ANNUAL REPORT | 2001-03-09 |
| ANNUAL REPORT | 2000-05-22 |
| Domestic Profit | 1999-04-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
