| Entity Name: | BAPTIST MEDICAL GROUP ORTHOPEDIC PRACTICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Sep 2009 (15 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L09000087965 |
| FEI/EIN Number | 270950931 |
| Address: | 1717 NORTH E STREET, STE. 320, PENSACOLA, FL, 32501 |
| Mail Address: | 1717 NORTH E STREET, STE. 320 - ATTN: MARY MATHEWS, PENSACOLA, FL, 32501 |
| ZIP code: | 32501 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831405745 | 2010-08-30 | 2010-08-30 | 1717 N E ST, SUITE 334, PENSACOLA, FL, 325016339, US | 1717 N E ST, SUITE 534, PENSACOLA, FL, 325016339, US | |||||||||||||||||
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| Phone | +1 850-437-8603 |
| Fax | 8504378601 |
| Phone | +1 850-432-3293 |
Authorized person
| Name | CARLA JOHNSON |
| Role | OPERATIONS ADMINISTRATOR |
| Phone | 8504378603 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CALLAHAN ELIZABETH | Agent | 1717 NORTH E ST., PENSACOLA, FL, 32501 |
| Name | Role | Address |
|---|---|---|
| VERMILLION KERRY W | Manager | 1717 NORTH E STREET, STE. 320, PENSACOLA, FL, 32501 |
| SKOLROOD KENT | Manager | 1717 NORTH E STREET, STE. 320, PENSACOLA, FL, 32501 |
| FAULKNER MARK T | Manager | 1717 NORTH E STREET, STE. 320, PENSACOLA, FL, 32501 |
| Name | Role | Address |
|---|---|---|
| Mathews Mary | Asst | 1717 North E St., Pensacola, FL, 32501 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000070785 | BAPTIST MEDICAL GROUP, SOUTHERN ORTHOPAEDICS | EXPIRED | 2010-08-02 | 2015-12-31 | No data | 1717 NORTH E STREET, SUITE 320, PENSACOLA, FL, 32501 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-26 | 1717 NORTH E STREET, STE. 320, PENSACOLA, FL 32501 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-26 | 1717 NORTH E STREET, STE. 320, PENSACOLA, FL 32501 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-26 | CALLAHAN, ELIZABETH | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-26 | 1717 NORTH E ST., STE. 320, PENSACOLA, FL 32501 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-26 |
| ANNUAL REPORT | 2012-04-26 |
| ANNUAL REPORT | 2011-04-13 |
| ANNUAL REPORT | 2010-08-04 |
| Florida Limited Liability | 2009-09-11 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
