R BRADLEY SHELDON MD PA
Marriage and Family Therapists at Racetrack Rd, Fort Walton Beach, FL

License number
Florida ME80982
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: MRS. ANITA D MOHNASKY
Title: OFFICE MANAGER
Phone: (850) 863-1920
Address
Address
350D Racetrack Rd NW, Fort Walton Beach, FL 32547
National Provider ID: 1518134717
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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R. BRADLEY SHELDON, M.D., PA

350 Racetrack Rd NW, Fort Walton Beach, FL 32547

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Oct 29, 2003
Inactive since:
Sep 25, 2009
State ID:
P03000125600
Business type:
Florida Profit Corporation
President, CEO, Chairman:
Richard B Sheldon President, CEO, Chairman, inactive, 350 Racetrack Rd NW, Fort Walton Beach, FL 32547 (Physical)
Agent:
R Sheldon,350 Racetrack Rd NW, Fort Walton Beach, FL 32547 (Physical)
EIN:
320094329

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