AGUSTIN R RODRIGUEZ
Medical Practice at Gibson Rd, Fort Walton Beach, FL

License number
Florida 17364
Issued Date
Dec 31, 1973
Effective Date
Feb 11, 2004
Expiration Date
Jan 31, 2004
Category
Health Care
Type
Medical Doctor
Address
Address
138 Gibson Rd, Fort Walton Beach, FL 32547
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Organization information

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AGUSTIN R. RODRIGUEZ, M. D., P. A

138 Gibson Rd % Augustin R Rodriguez, Ft Walton Bch, FL 32547

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Sep 9, 1982
Inactive since:
Oct 1, 2004
State ID:
F98789
Business type:
Florida Profit Corporation
S:
Agustin R. Rodriguez,Sara Rodriguez
Agent:
M. Rodriguez,138 Gibson Rd, Ft Walton Bch, FL 32547 (Physical)
FEI/EIN:
59-2215402

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