{"entity":{"id":10303909,"state":"FL","state_id":"F01204","entity_name":"GLEN WAGNER, M.D., P.A.","entity_type":"DOMP","entity_type_normalized":"domestic_profit","status":"I","filing_date":"1980-10-10","filing_year":1980,"business_age_years":46,"principal_address1":"121 6TH AVE.","principal_address2":"PO BOX 033609","principal_city":"INDIALANTIC","principal_state":"FL","principal_zip":"32903-7609","principal_country":"","mail_address1":"121 6TH AVE.","mail_address2":"PO BOX 033609","mail_city":"INDIALANTIC","mail_state":"FL","mail_zip":"32903-7609","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"592037474","jurisdiction":null,"county":null,"last_transaction_date":"09192003","report_year_1":"2002","report_date_1":"02132002","report_year_2":"2002","report_date_2":"02132002","report_year_3":"2001","report_date_3":"01312001","agent_name":"Glen Wagner","agent_type":"P","agent_address":"121 6TH AVE.","agent_city":"INDIALANTIC","agent_state":"FL","agent_zip":"32903","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata4.txt","fetched_at":"2026-05-09 12:09:41","updated_at":"2026-05-09 12:09:41","last_accessed":null,"status_reason":null,"agent_name_raw":"WAGNER              GLEN"},"officers":[{"name":"Glen Wagner","first_name":"Glen","last_name":"Wagner","title":"President, Director","title_roles":["President","Director"],"title_code":"pd","is_registered_agent":false,"address":"121 6TH AVENUE","city":"INDIALANTIC","state":"FL","zip":"","name_raw":"WAGNER, GLEN"}],"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/F01204"}