| Entity Name: | PRIMARY CARE PHYSICIANS OF GAINESVILLE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Aug 1986 (38 years ago) |
| Document Number: | J30798 |
| FEI/EIN Number | 592710945 |
| Address: | 3780 NW 83RD ST., GAINESVILLE, FL, 32606, US |
| Mail Address: | 3780 NW 83RD ST., GAINESVILLE, FL, 32606, US |
| ZIP code: | 32606 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649293648 | 2006-07-25 | 2018-08-16 | 3780 NW 83RD ST, GAINESVILLE, FL, 326065603, US | 3780 NW 83RD ST, GAINESVILLE, FL, 32606, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 352-377-2022 |
| Fax | 3523779113 |
Authorized person
| Name | JAMIE ENTREKIN |
| Role | OFFICE MANAGER |
| Phone | 3523772022 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 016400509 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SANDERS ELIZABETH C | Agent | 3780 NW 83RD STREET, GAINESVILLE, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| SANDERS ELIZABETH C | President | 3780 NW 83RD, GAINESVILLE, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| Gruninger Patrick R | Secretary | 3780 NW 83rd Street, Gainesville, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| Gruninger Patrick R | Vice President | 3780 NW 83rd Street, Gainesville, FL, 32606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-12-06 | No data | No data |
| REINSTATEMENT | 2015-12-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| NAME CHANGE AMENDMENT | 1996-06-14 | PRIMARY CARE PHYSICIANS OF GAINESVILLE, P.A. | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
