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MAINLAND PHYSICIANS GROUP, LLC

Company Details

Entity Name: MAINLAND PHYSICIANS GROUP, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 21 Jan 2016 (9 years ago)
Date of dissolution: 27 Sep 2024 (4 months ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (4 months ago)
Document Number: L16000015045
FEI/EIN Number 81-2573288
Address: 100 ARRICOLA AVE, ST AUGUSTINE, FL, 32080
Mail Address: 100 ARRICOLA AVE, ST AUGUSTINE, FL, 32080
ZIP code: 32080
County: St. Johns
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003419763 2020-11-17 2020-11-17 100 ARRICOLA AVE, ST AUGUSTINE, FL, 320804515, US 100 ARRICOLA AVE, ST AUGUSTINE, FL, 320804515, US

Contacts

Phone +1 904-825-4368
Fax 9048259107

Authorized person

Name MR. JOHN PAUL JAMES SHADDOCK
Role DIRECTOR OF NETWORK MANAGMENT
Phone 8503416322

Taxonomy

Taxonomy Code 207QG0300X - Geriatric Medicine (Family Medicine) Physician
Is Primary Yes

Agent

Name Role Address
HINMAN ROY HII Agent 100 ARRICOLA AVE, ST AUGUSTINE, FL, 32080

Manager

Name Role Address
HINMAN ROY HII Manager 100 ARRICOLA AVE, ST AUGUSTINE, FL, 32080

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000064113 MEDICAL HEALTH CENTERS ACTIVE 2023-05-23 2028-12-31 No data 100 ARRICOLA AVE, ST AUGUSTINE, FL, 32080

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 No data No data
REGISTERED AGENT NAME CHANGED 2019-04-03 HINMAN, ROY H, II No data
REGISTERED AGENT ADDRESS CHANGED 2019-04-03 100 ARRICOLA AVE, ST AUGUSTINE, FL 32080 No data

Documents

Name Date
ANNUAL REPORT 2023-03-09
ANNUAL REPORT 2022-01-21
ANNUAL REPORT 2021-03-23
ANNUAL REPORT 2020-03-16
ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2018-03-07
ANNUAL REPORT 2017-02-08
Florida Limited Liability 2016-01-21

Date of last update: 02 Feb 2025

Sources: Florida Department of State