| Entity Name: | KEITH A. BAKER, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 09 Oct 1990 (34 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | S05740 |
| FEI/EIN Number | 65-0229861 |
| Address: | OAK TREE TERRACE, 418 SW 47TH TERRACE, CAPE CORAL, FL 33914 |
| Mail Address: | P O BOX 152387, 418 SW 47TH TERRACE, CAPE CORAL, FL 33915 |
| ZIP code: | 33914 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043264245 | 2006-05-20 | 2020-08-22 | PO BOX 152387, CAPE CORAL, FL, 339152387, US | 418 SW 47TH TER, CAPE CORAL, FL, 339146506, US | |||||||||||||||||||||
|
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| Phone | +1 239-945-1910 |
| Fax | 2399452392 |
| Phone | +1 239-945-1919 |
Authorized person
| Name | KEITH A BAKER |
| Role | PRESIDENT |
| Phone | 2399451910 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS4653 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BAKER, KEITH A. | Agent | OAK TREE TERRACE, 418 SW 47TH TERRACE, CAPE CORAL, FL 33914 |
| Name | Role | Address |
|---|---|---|
| BAKER, KEITH A | President | 418 SW 47TH TERR, PO BOX 152387, CAPE CORAL, FL 33915 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-02-18 | OAK TREE TERRACE, 418 SW 47TH TERRACE, CAPE CORAL, FL 33914 | No data |
| CHANGE OF MAILING ADDRESS | 2005-02-23 | OAK TREE TERRACE, 418 SW 47TH TERRACE, CAPE CORAL, FL 33914 | No data |
| REINSTATEMENT | 1991-11-12 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1991-11-12 | OAK TREE TERRACE, 418 SW 47TH TERRACE, CAPE CORAL, FL 33914 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1991-10-11 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-23 |
| ANNUAL REPORT | 2014-04-18 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-04-11 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-25 |
| ANNUAL REPORT | 2009-04-13 |
| ANNUAL REPORT | 2008-02-18 |
| ANNUAL REPORT | 2007-04-17 |
| ANNUAL REPORT | 2006-01-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
