| Entity Name: | MEDICAL HOME, PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Oct 2010 (14 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 20 Mar 2015 (10 years ago) |
| Document Number: | L10000105361 |
| FEI/EIN Number | 273640754 |
| Address: | 1811 DR MARTIN LUTHER KING JR ST N, ST. PETERSBURG, FL, 33704, US |
| Mail Address: | 1811 DR MARTIN LUTHER KING JR ST N, ST. PETERSBURG, FL, 33704, US |
| ZIP code: | 33704 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629485271 | 2014-07-16 | 2022-06-11 | PO BOX 7651, SAINT PETERSBURG, FL, 337347651, US | 4401 4TH ST N, SAINT PETERSBURG, FL, 337034728, US | |||||||||||||||||||||
|
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| Phone | +1 727-922-0009 |
| Fax | 7275257788 |
| Phone | +1 727-525-4401 |
Authorized person
| Name | MR. FRED ELTON CLARK III |
| Role | OWNER |
| Phone | 7275254401 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME102187 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Clark Fred EIII | Agent | 490 Lido Way NE, Saint Petersburg, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| CLARK FRED EIII | Manager | 490 LIDO WAY NE, SAINT PETERSBURG, FL, 33704 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000106523 | ALLCARE CLINIC | ACTIVE | 2016-09-28 | 2026-12-31 | No data | 1811 9TH ST N, ST. PETERSBURG, FL, 33704 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-26 | 1811 DR MARTIN LUTHER KING JR ST N, ST. PETERSBURG, FL 33704 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-26 | 1811 DR MARTIN LUTHER KING JR ST N, ST. PETERSBURG, FL 33704 | No data |
| REINSTATEMENT | 2015-03-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-03-20 | Clark, Fred E, III | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-20 | 490 Lido Way NE, Saint Petersburg, FL 33704 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-06-07 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-01-28 |
| ANNUAL REPORT | 2016-02-14 |
| REINSTATEMENT | 2015-03-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
