| Entity Name: | CAPITAL MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Nov 2012 (12 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L12000150396 |
| FEI/EIN Number | 46-1486313 |
| Address: | 5985 49TH ST. NORTH, ST. PETERSBURG, FL, 33709, US |
| Mail Address: | P O BOX 3377, PINELLAS PARK, FL, 33780, US |
| ZIP code: | 33709 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427394303 | 2012-12-20 | 2012-12-20 | PO BOX 3377, PINELLAS PARK, FL, 337803377, US | 5985 49TH ST N, ST PETERSBURG, FL, 337092111, US | |||||||||||||||||||||||||||
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| Phone | +1 727-408-3232 |
| Fax | 7275273715 |
Authorized person
| Name | PHYLLIS FRIEDRICH |
| Role | VP OPERATIONS AND BUS DEVELOPMENT |
| Phone | 7274083232 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207QG0300X - Geriatric Medicine (Family Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SHASTRI MILIND | Agent | 5985 49TH ST. NORTH, ST. PETERSBURG, FL, 33709 |
| Name | Role | Address |
|---|---|---|
| SHASTRI MILIND | Managing Member | 5985 49TH ST NORTH, ST. PETERSBURG, FL, 33709 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-02-25 | 5985 49TH ST. NORTH, ST. PETERSBURG, FL 33709 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-07-11 |
| ANNUAL REPORT | 2015-01-14 |
| ANNUAL REPORT | 2014-04-29 |
| ANNUAL REPORT | 2013-02-25 |
| Florida Limited Liability | 2012-11-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
