| Entity Name: | SOUTHERN BAPTIST HOSPITAL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Non-Profit |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Jul 1953 (72 years ago) |
| Date of dissolution: | 21 Oct 1974 (50 years ago) |
| Last Event: | DISSOLVED BY PROCLAMATION |
| Event Date Filed: | 21 Oct 1974 (50 years ago) |
| Document Number: | 809419 |
| FEI/EIN Number |
000000000
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 800 PRUDENTIAL DR., JACKSONVILLE FLA, 32207 |
| Mail Address: | 800 PRUDENTIAL DR., JACKSONVILLE FLA, 32207 |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | LOUISIANA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861693632 | 2007-05-30 | 2020-08-22 | 4160 UNIVERSITY BLVD S, JACKSONVILLE, FL, 322164317, US | 96098 VICTORIAS PL, SUITE 201, YULEE, FL, 320976349, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 904-376-3800 |
| Fax | 9047339598 |
Authorized person
| Name | DR. ELLEN WILLIAMS |
| Role | DIRECTOR |
| Phone | 9043763800 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC1900X - Counseling Psychologist |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CAMP, GERALD | Secretary | 7224 LORAIN, JACKSONVILLE, FL |
| LIPSCOMB, CLYDE B. | President | 4344 LANDOVER DR., JACKSONVILLE, FL |
| GOODING, MARION W. | Vice President | 4105 SAN JOSE BLVD., JACKSONVILLE, FL |
| SANDLER, LLC | Director | - |
| PRICE, ZINN O | Director | 12570 MANDARIN RD., JACKSONVILLE, FL |
| HARDEN, M.C. | Director | P. O. BOX 3214, JACKSONVILLE, FL |
| FAY, LAWRENCE D. | Agent | JACKSONVILLE, FL, 32202 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| DISSOLVED BY PROCLAMATION | 1974-10-21 | - | - |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
