Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

FLORIDA ASSOCIATION OF PEDIATRIC CRITICAL CARE MEDICINE, INC.

Filing Information
N34055 59-2967556 09/05/1989 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 10/01/2004 NONE
Principal Address
1600 S ANDREWS AVE
BROWARD GRL MED CR, 7TH FLPICU OFFICE
FORT LAUDERDALE, FL 33316

Changed: 04/10/2001
Mailing Address
2110 W. M.L. KING BLVD
TAMPA, FL 33607

Changed: 03/19/1993
Registered Agent Name & Address HINES, JAMES P.
315 HYDE PARK AVE
TAMPA, FL
Officer/Director Detail Name & Address

Title DVP

NORTHRUP, REX
5153 NORTH 9TH AVENUE
PENSACOLA, FL 32504

Title PD

DENICOLA, LUCIAN
820 PRUDENTIAL DR #208 HOWARD BLDG
JACKSONVILLE, FL 32207

Title ST

TOROE, JORGE D
1600 S.ANDREW AVE,7TH FL
FORT LAUDERDALE, FL 33316

Title D

SUSSMANEA, JEFFREY
3100 SW 62 AVENUE
MIAMI, FL 33155

Title D

SWANSON, MARK
83 W.COLOMBIA STREET
ORLANDO, FL 32806

Annual Reports
Report YearFiled Date
2001 04/10/2001
2003 07/02/2003