| Entity Name: | DEAN HILDAHL, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Jul 1999 (26 years ago) |
| Document Number: | P99000068503 |
| FEI/EIN Number | 593587922 |
| Address: | 1865 Veterans Park Drive, NAPLES, FL, 34109, US |
| Mail Address: | 1865 Veterans Park Dr, NAPLES, FL, 34109, US |
| ZIP code: | 34109 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760589048 | 2006-09-20 | 2020-08-22 | 5500 BRYSON DR STE 301, NAPLES, FL, 341090921, US | 5500 BRYSON DR STE 301, NAPLES, FL, 341090921, US | |||||||||||||||||||||||||
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| Phone | +1 239-593-5510 |
| Fax | 2395935414 |
Authorized person
| Name | DEAN BOYD HILDAHL |
| Role | PHYSICIAN/ OWNER |
| Phone | 2395935510 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME72896 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 41706 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HILDAHL DEAN | Agent | 6661 SANDALWOOD LANE, NAPLES, FL, 34109 |
| Name | Role | Address |
|---|---|---|
| HILDAHL DEAN | Director | 6661 SANDALWOOD LANE, NAPLES, FL, 34109 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000009174 | NORTH NAPLES GYNECOLOGY AND OBSTETRICS | EXPIRED | 2010-01-28 | 2015-12-31 | No data | 5500 BRYSON DRIVE SUITE 301, NAPLES, FL, 34109 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-21 | 1865 Veterans Park Drive, 201, NAPLES, FL 34109 | No data |
| CHANGE OF MAILING ADDRESS | 2020-01-21 | 1865 Veterans Park Drive, 201, NAPLES, FL 34109 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-03-08 | 6661 SANDALWOOD LANE, NAPLES, FL 34109 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-27 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
