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  5. FAMILY MEDICAL GROUP, P.A.

FAMILY MEDICAL GROUP, P.A. - Florida Company Profile

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Company Details

Entity Name: FAMILY MEDICAL GROUP, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 27 Feb 1986 (40 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 05 Nov 2003 (22 years ago)
Document Number: J01455
FEI/EIN Number 592645885
Address: 113 HEALTH WAY, LAKE PLACID, FL, 33852, US
Mail Address: 113 HEALTH WAY, LAKE PLACID, FL, 33852, US
ZIP code: 33852
City: Lake Placid
County: Highlands
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CORREDERA WILFREDO MD President 113 HEALTH WAY, LAKE PLACID, FL, 33852
MONTERO DANIEL EMD Vice President 113 HEALTH WAY, LAKE PLACID, FL, 33852
CORREDERA WILFREDO MD Agent 113 HEALTH WAY, LAKE PLACID, FL, 33852

Commercial and government entity program

CAGE number:
92J60
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2023-06-25
CAGE Expiration:
2026-06-25
SAM Expiration:
2022-07-23

Contact Information

POC:
JOANNE STAYTON

National Provider Identifier

NPI Number:
1215099007
Certification Date:
2021-05-11
Link:
View on NPI website

Authorized Person:

Name:
JOANNE E STAYTON
Role:
PRACTICE ADMINISTRATOR
Phone:
8634657010

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Phone:
+1 863-465-7010

Form 5500 Series

Employer Identification Number (EIN):
592645885
Plan Year:
2011
Number Of Participants:
31
Sponsors Telephone Number:
8634657010
File:
View File
Plan Year:
2010
Number Of Participants:
26
Sponsors Telephone Number:
8634657010
File:
View File
Plan Year:
2009
Number Of Participants:
28
Sponsors Telephone Number:
8634657010
File:
View File

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2020-12-07 113 HEALTH WAY, LAKE PLACID, FL 33852 -
CHANGE OF PRINCIPAL ADDRESS 2020-08-27 113 HEALTH WAY, LAKE PLACID, FL 33852 -
CHANGE OF MAILING ADDRESS 2020-08-27 113 HEALTH WAY, LAKE PLACID, FL 33852 -
REGISTERED AGENT NAME CHANGED 2020-03-10 CORREDERA, WILFREDO, MD -
NAME CHANGE AMENDMENT 2003-11-05 FAMILY MEDICAL GROUP, P.A. -
REINSTATEMENT 1987-12-21 - -
INVOLUNTARILY DISSOLVED 1987-11-16 - -

Documents

Name Date
ANNUAL REPORT 2024-03-08
ANNUAL REPORT 2023-01-20
ANNUAL REPORT 2022-01-10
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-03-10
Reg. Agent Change 2020-03-10
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-01-11
ANNUAL REPORT 2017-02-28
ANNUAL REPORT 2016-01-21

USAspending Awards / Financial Assistance

Date:
2021-02-10
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
266817.00
Total Face Value Of Loan:
266817.00
Date:
2020-04-16
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-08
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
302727.00
Total Face Value Of Loan:
302727.00
Date:
2020-04-08
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
302727.00
Total Face Value Of Loan:
302727.00

OSHA's Inspections within Industry

Inspection Summary

Date:
2013-01-10
Type:
Prog Related
Address:
105 TOMOKA BLVD S, LAKE PLACID, FL, 33852
Safety Health:
Health
Scope:
Partial

Paycheck Protection Program

Jobs Reported:
28
Initial Approval Amount:
$302,727
Date Approved:
2020-04-08
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$302,727
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$305,182.45
Servicing Lender:
Heartland National Bank
Use of Proceeds:
Payroll: $302,725
Utilities: $1
Mortgage Interest: $1
Jobs Reported:
33
Initial Approval Amount:
$266,817
Date Approved:
2021-02-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$266,817
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$268,521.66
Servicing Lender:
Heartland National Bank
Use of Proceeds:
Payroll: $266,814
Utilities: $1

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Date of last update: 02 Aug 2025

Sources: Florida Department of State

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