| Entity Name: | PROMISE MEDICAL GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PROMISE MEDICAL GROUP, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 05 Sep 2012 (13 years ago) |
| Document Number: | L12000114063 |
| FEI/EIN Number |
46-0918380
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 9202 NW 26th Street, Wildwood, FL, 34785, US |
| Mail Address: | 9202 NW 26th Street, Wildwood, FL, 34785, US |
| ZIP code: | 34785 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043560832 | 2012-09-19 | 2024-07-29 | 9202 NW 26TH ST, WILDWOOD, FL, 347857413, US | 9202 NW 26TH ST, WILDWOOD, FL, 347857413, US | |||||||||||||||||||||||||
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| Phone | +1 352-812-0579 |
| Fax | 3525714349 |
Authorized person
| Name | DR. DAVID WAYNE STEPHENSON |
| Role | PRESIDENT |
| Phone | 3528120579 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME106525 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | FD876Z |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STEPHENSON DAVID W | Managing Member | 9202 NW 26th Street, Wildwood, FL, 34785 |
| STEPHENSON DAVID W | Agent | 9202 NW 26th Street, Wildwood, FL, 34785 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-28 | 9202 NW 26th Street, Wildwood, FL 34785 | - |
| CHANGE OF MAILING ADDRESS | 2018-03-28 | 9202 NW 26th Street, Wildwood, FL 34785 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-28 | 9202 NW 26th Street, Wildwood, FL 34785 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-04-18 |
| ANNUAL REPORT | 2015-04-09 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
