| Entity Name: | AMELIA INTERNAL MEDICINE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Oct 1999 (25 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P99000093968 |
| FEI/EIN Number | 593612375 |
| Address: | 1250 SOUTH 18TH ST., SUITE 202, FERNANDINA BEACH, FL, 32034 |
| Mail Address: | 1250 SOUTH 18TH ST., SUITE 202, FERNANDINA BEACH, FL, 32034 |
| ZIP code: | 32034 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083605349 | 2005-11-04 | 2011-03-11 | 1250 S 18TH ST, SUITE 202, FERNANDINA BEACH, FL, 320341902, US | 1250 S 18TH ST, SUITE 202, FERNANDINA BEACH, FL, 320341902, US | |||||||||||||||
|
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| Phone | +1 904-277-4690 |
| Fax | 9042778487 |
Authorized person
| Name | GERALD B BURFORD |
| Role | PRESIDENT |
| Phone | 9042774690 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAVIS CLYDE W | Agent | 1250 SOUTH 18TH ST., FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| BURFORD GERALD B | Director | 1250 SOUTH 18TH ST., FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| DEVANE PHILIP T | Secretary | 1250 SOUTH 18TH ST., FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| RODEFFER HENRY D | Vice President | 1250 SOUTH 18TH ST., FERNANDINA BEACH, FL, 32034 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-03-06 | DAVIS, CLYDE W. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-06 | 1250 SOUTH 18TH ST., SUITE 202, FERNANDINA BEACH, FL 32034 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-01-10 | 1250 SOUTH 18TH ST., SUITE 202, FERNANDINA BEACH, FL 32034 | No data |
| CHANGE OF MAILING ADDRESS | 2005-01-10 | 1250 SOUTH 18TH ST., SUITE 202, FERNANDINA BEACH, FL 32034 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-03-01 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-07 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-01-02 |
| ANNUAL REPORT | 2012-01-04 |
| ANNUAL REPORT | 2011-01-05 |
| ANNUAL REPORT | 2010-01-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
