| Entity Name: | CRISTINA M. BABIAK, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 May 1999 (26 years ago) |
| Document Number: | P99000041520 |
| FEI/EIN Number | 650921413 |
| Address: | 1790 7TH ST, ENGLEWOOD, FL, 34223 |
| Mail Address: | 1790 7TH ST, ENGLEWOOD, FL, 34223 |
| ZIP code: | 34223 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568640472 | 2008-02-01 | 2014-09-10 | 1790 7TH ST, ENGLEWOOD, FL, 342236495, US | 1790 7TH ST, ENGLEWOOD, FL, 342236495, US | |||||||||||||||||
|
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| Phone | +1 941-474-6593 |
Authorized person
| Name | DR. CRISTINA BABIAK |
| Role | OWNER |
| Phone | 9414746539 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME36537 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REEGLER SARI L | Agent | 1521 S. TAMIAMI TRAIL STE. 304, VENICE, FL, 34292 |
| Name | Role | Address |
|---|---|---|
| BABIAK CRISTINA M | Director | 1790 7TH ST, ENGLEWOOD, FL, 34223 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-01-16 | No data | No data |
| NAME CHANGE AMENDMENT | 1999-07-19 | CRISTINA M. BABIAK, M.D., P.A. | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
