| Entity Name: | NORTHWEST FLORIDA PHYSICIANS GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Aug 2013 (11 years ago) |
| Document Number: | L13000119486 |
| FEI/EIN Number | 61-1721031 |
| Address: | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 |
| Mail Address: | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 |
| ZIP code: | 32506 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538594262 | 2013-09-12 | 2013-09-12 | 730 N NEW WARRINGTON RD, PENSACOLA, FL, 325064247, US | 730 N NEW WARRINGTON RD, PENSACOLA, FL, 325064247, US | |||||||||||||
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| Phone | +1 850-456-4788 |
Authorized person
| Name | DR. THOMAS ALLEN ROBERTS |
| Role | PRES/OWNER |
| Phone | 8506072363 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHWEST FLORIDA PHYSICIANS GROUP, LLC 401(K) PLAN | 2023 | 611721031 | 2024-04-18 | NORTHWEST FLORIDA PHYSICIANS GROUP, LLC | 11 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-04-18 |
| Name of individual signing | MIKE TIBOLET |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ROBERTS, THOMAS | Agent | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 |
| Name | Role | Address |
|---|---|---|
| ROBERTS, THOMAS | Manager | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000114714 | NORTHWEST FLORIDA PHYSICIANS GROUP, LLC | EXPIRED | 2016-10-21 | 2021-12-31 | No data | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL, 32506 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-10 | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 | No data |
| CHANGE OF MAILING ADDRESS | 2017-02-10 | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-02-10 | 730 N NEW WARRINGTON ROAD, PENSACOLA, FL 32506 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-02-03 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
