MID-BAY WOMEN'S CLINIC, P.A.
Ambulatory Health at Highway 20, Niceville, FL

License number
Florida ME63811
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: DR. MAUREEN E THOMPSON M.D.
Title: OWNER
Phone: (850) 897-7277
Address
Address
4400 E Highway 20 SUITE 209, Niceville, FL 32578
National Provider ID: 1144537572
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MID-BAY WOMEN'S CLINIC, PA

4400 Hwy 20 E STE 209, Niceville, FL 32578

Status:
Inactive
Inactive reason:
Admin Dissolution For Annual Report
Registration:
Apr 1, 1996
Inactive since:
Sep 26, 2014
State ID:
P96000029854
Business type:
Florida Profit Corporation
Director,s:
Maureen E Thompson Director, inactive, 4400 Hwy 20 E STE 209, Niceville, FL 32578 (Physical),John C Thompson Director,, inactive, 4400 Hwy 20 E STE 209, Niceville, FL 32578 (Physical)
Agent:
John Thompson,4418 Windlake Dr, Niceville, FL 32578 (Physical)
EIN:
59-3372364

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