| Entity Name: | MARION OAKS MEDICAL CLINIC OF CENTRAL FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Oct 1999 (25 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P99000090615 |
| FEI/EIN Number | 593647622 |
| Address: | 13795 SW 36TH AVE, RD., SUITE 4, OCALA, FL, 34473 |
| Mail Address: | 13795 SW 36TH AVE, RD., SUITE 4, OCALA, FL, 34473 |
| ZIP code: | 34473 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225085327 | 2006-05-27 | 2014-01-24 | 13795 SW 36TH AVENUE RD, OCALA, FL, 344736104, US | 13795 SW 36TH AVENUE RD, OCALA, FL, 344736104, US | |||||||||||||||||||||
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| Phone | +1 352-347-5444 |
| Fax | 3523473162 |
Authorized person
| Name | DR. ANTHONY EWERE OKOH |
| Role | MEDICAL DIRECTOR |
| Phone | 3523475444 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 269599500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TWENEBOAH KWAME | Agent | 5460 NORTH STATE ROAD 7, NORTH LAUDERDALE, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| OKOH ANTHONY E | President | 13795 SW 36TH AVE. ROAD, OCALA, FL, 34473 |
| Name | Role | Address |
|---|---|---|
| SINCLAIR MERRIT | Vice President | 13795 SW 36TH AVE. ROAD, OCALA, FL, 34473 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-01-08 | TWENEBOAH, KWAME | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-08 | 5460 NORTH STATE ROAD 7, SUITE 120, NORTH LAUDERDALE, FL 33319 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-02-16 | 13795 SW 36TH AVE, RD., SUITE 4, OCALA, FL 34473 | No data |
| CHANGE OF MAILING ADDRESS | 2010-02-16 | 13795 SW 36TH AVE, RD., SUITE 4, OCALA, FL 34473 | No data |
| REINSTATEMENT | 2001-01-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2000-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-27 |
| ANNUAL REPORT | 2016-02-16 |
| ANNUAL REPORT | 2015-01-21 |
| ANNUAL REPORT | 2014-01-08 |
| ANNUAL REPORT | 2013-01-23 |
| ANNUAL REPORT | 2012-01-04 |
| ANNUAL REPORT | 2011-01-12 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-01-15 |
| ANNUAL REPORT | 2008-01-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
