{"entity":{"id":5122650,"state":"FL","state_id":"604190","entity_name":"W. DOUGLAS FOWLER, JR., M.D., P.A.","entity_type":"DOMP","entity_type_normalized":"domestic_profit","status":"I","filing_date":"02271973","filing_year":1973,"business_age_years":53,"principal_address1":"804 THIRD ST., STE A","principal_address2":"","principal_city":"NEPTUNE BEACH","principal_state":"FL","principal_zip":"32233-2018","principal_country":"","mail_address1":"804 THIRD ST., STE A","mail_address2":"","mail_city":"NEPTUNE BEACH","mail_state":"FL","mail_zip":"32233-2018","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"591449620","jurisdiction":null,"county":null,"last_transaction_date":"11041988","report_year_1":"1987","report_date_1":"03051987","report_year_2":"1987","report_date_2":"03051987","report_year_3":"1986","report_date_3":"03131986","agent_name":"W. Douglas Fowler","agent_type":"C","agent_address":"804-A 3RD ST","agent_city":"NEPTUNE BEACH","agent_state":"FL","agent_zip":"322332018","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata0.txt","fetched_at":"2026-05-09 08:50:10","updated_at":"2026-05-09 08:50:10","last_accessed":null,"status_reason":null,"agent_name_raw":"FOWLER, W. DOUGLAS"},"officers":[{"name":"Robert Dehgan","first_name":"Robert","last_name":"Dehgan","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"315 11TH AVENUE NORTH","city":"JACKSONVILLE BCH","state":"FL","zip":"","name_raw":"DEHGAN, ROBERT"},{"name":"W. Douglas Fowler","first_name":"W.","last_name":"Fowler","title":"Treasurer","title_roles":["Treasurer"],"title_code":"treasurer","is_registered_agent":true,"address":"804-A 3RD ST","city":"NEPTUNE BEACH","state":"FL","zip":"","name_raw":"FOWLER, W. DOUGLAS"},{"name":"W. Douglas, Fowler JR","first_name":"W.","last_name":"Fowler","title":"President, Director","title_roles":["President","Director"],"title_code":"pd","is_registered_agent":false,"address":"804-A 3RD ST","city":"NEPTUNE BEACH","state":"FL","zip":"","name_raw":"FOWLER, W. DOUGLAS, JR."},{"name":"Clifford J. Jeremiah","first_name":"Clifford","last_name":"Jeremiah","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"3625 UNIVERSITY BLVD. S.","city":"JACKSONVILLE","state":"FL","zip":"","name_raw":"JEREMIAH, CLIFFORD J."}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/604190"}