| Entity Name: | ROBERTA A. MIX, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
ROBERTA A. MIX, D.O., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 03 May 1999 (26 years ago) |
| Date of dissolution: | 25 Sep 2015 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (10 years ago) |
| Document Number: | P99000040615 |
| FEI/EIN Number |
593585245
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2102 TRINITY OAKS BLVD, STE 201, NEW PORT RICHEY, FL, 34655 |
| Mail Address: | 5117 JEWELL TERRACE, PALM HARBOR, FL, 34685 |
| ZIP code: | 34655 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831282110 | 2006-10-01 | 2012-11-26 | 2102 TRINITY OAKS BLVD, SUITE 201, TRINITY, FL, 346554409, US | 2102 TRINITY OAKS BLVD, SUITE 201, TRINITY, FL, 346554409, US | |||||||||||||||||||||||||||||||
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| Phone | +1 727-376-8885 |
| Fax | 7273767997 |
Authorized person
| Name | DR. ROBERTA ANN MIX |
| Role | PRESIDENT |
| Phone | 7273768885 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS7532 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2563461-00 |
| State | FL |
| Issuer | DME |
| Number | 4867933001 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MIX ROBERTA A | Director | 2102 TRINITY OAKS BLVD., STE 127, NEW PORT RICHEY, FL, 34655 |
| MIX ROBERTA A | President | 2102 TRINITY OAKS BLVD., STE 127, NEW PORT RICHEY, FL, 34655 |
| MIX ROBERTA A | Secretary | 2102 TRINITY OAKS BLVD., STE 127, NEW PORT RICHEY, FL, 34655 |
| Carson John L | Chief Financial Officer | 5117 Jewell Terrace, Palm Harbor, FL, 34685 |
| MIX ROBERTA A | Agent | 5117 JEWELL TERRACE, PALM HARBOR, FL, 34685 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| CHANGE OF MAILING ADDRESS | 2015-01-20 | 2102 TRINITY OAKS BLVD, STE 201, NEW PORT RICHEY, FL 34655 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-20 | 5117 JEWELL TERRACE, PALM HARBOR, FL 34685 | - |
| REGISTERED AGENT NAME CHANGED | 2015-01-20 | MIX, ROBERTA A | - |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-23 | 2102 TRINITY OAKS BLVD, STE 201, NEW PORT RICHEY, FL 34655 | - |
| REINSTATEMENT | 2009-04-09 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | - | - |
| Name | Date |
|---|---|
| Reg. Agent Change | 2015-01-20 |
| ANNUAL REPORT | 2014-03-27 |
| ANNUAL REPORT | 2013-03-21 |
| ANNUAL REPORT | 2012-04-12 |
| ANNUAL REPORT | 2011-02-23 |
| ANNUAL REPORT | 2010-04-04 |
| REINSTATEMENT | 2009-04-09 |
| ANNUAL REPORT | 2007-01-23 |
| ANNUAL REPORT | 2006-01-08 |
| ANNUAL REPORT | 2005-01-23 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
