| Entity Name: | MAGNOLIA PEDIATRICS GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Feb 2013 (12 years ago) |
| Last Event: | LC ARTICLE OF CORRECTION |
| Event Date Filed: | 20 Feb 2013 (12 years ago) |
| Document Number: | L13000019161 |
| FEI/EIN Number | 37-1712499 |
| Mail Address: | 535 John Knox Road, TALLAHASSEE, FL, 32303, US |
| Address: | 2406 E. Plaza Drive, TALLAHASSEE, FL, 32308, US |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134679442 | 2016-10-11 | 2016-10-11 | 111 S MAGNOLIA DR STE 10, TALLAHASSEE, FL, 323012956, US | 111 S MAGNOLIA DR STE 10, TALLAHASSEE, FL, 323012956, US | |||||||||||||||||||
|
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| Phone | +1 850-878-5322 |
| Fax | 8508783120 |
Authorized person
| Name | DR. TODD PATTERSON |
| Role | PHYSICIAN/OWNER |
| Phone | 8508785322 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | RN9308662 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WINN JASON D | Agent | 119 E PARK AVE, TALLAHASSEE, FL, 32301 |
| Name | Role | Address |
|---|---|---|
| PATTERSON TODD A | Managing Member | 535 John Knox Road, TALLAHASSEE, FL, 32303 |
| Name | Role | Address |
|---|---|---|
| Phillips Joan E | Manager | 535 John Knox Road, TALLAHASSEE, FL, 32303 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-05-01 | 2406 E. Plaza Drive, TALLAHASSEE, FL 32308 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-28 | 2406 E. Plaza Drive, TALLAHASSEE, FL 32308 | No data |
| LC ARTICLE OF CORRECTION | 2013-02-20 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
