| Entity Name: | SHAW MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SHAW MEDICAL GROUP LLC 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: | 20 Jun 2016 (9 years ago) |
| Document Number: | L16000118442 |
| FEI/EIN Number |
81-3035276
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 947 Barefoot Blvd, Barefoot Bay, FL, 32976-7101, US |
| Mail Address: | 947 Barefoot Blvd, Barefoot Bay, FL, 32976-7101, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255884938 | 2016-07-28 | 2023-05-25 | 947 BAREFOOT BLVD, BAREFOOT BAY, FL, 329767101, US | 947 BAREFOOT BLVD, BAREFOOT BAY, FL, 329767101, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 321-593-6999 |
| Fax | 3213272262 |
Authorized person
| Name | DR. CARMENCITA E SHAW |
| Role | PROVIDER |
| Phone | 3215936999 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019884700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 019879900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHAW MEDICAL GROUP LLC | Othe | - |
| SHAW PATRICK N | Agent | 947 Barefoot Blvd, Barefoot Bay, FL, 329767101 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-07 | 947 Barefoot Blvd, Barefoot Bay, FL 32976-7101 | - |
| CHANGE OF MAILING ADDRESS | 2023-02-07 | 947 Barefoot Blvd, Barefoot Bay, FL 32976-7101 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-07 | 947 Barefoot Blvd, Barefoot Bay, FL 32976-7101 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-06-21 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-02-11 |
| Florida Limited Liability | 2016-06-20 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1254147104 | 2020-04-10 | 0455 | PPP | 8000 Ron Beatty Blvd, Micco, FL, 32976-7438 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7133288402 | 2021-02-11 | 0455 | PPS | 8000 Ron Beatty Blvd, Micco, FL, 32976-7438 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Status | User ID | Name of Firm | Trade Name | UEI | Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Active | P2488697 | SHAW MEDICAL GROUP LLC | - | VK2YB7NTQ483 | 947 BAREFOOT BLVD, BAREFOOT BAY, FL, 32976-7101 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Name | Patrick Shaw |
| Role | President |
SBA Federal Certifications
| HUBZone Certified | No |
| Women Owned Certified | No |
| Women Owned Pending | No |
| Economically Disadvantaged Women Owned Certified | No |
| Economically Disadvantaged Women Owned Pending | No |
| Veteran-Owned Small Business Certified | No |
| Veteran-Owned Small Business Joint Venture | No |
| Service-Disabled Veteran-Owned Small Business Certified | No |
| Service-Disabled Veteran-Owned Small Business Joint Venture | No |
Bonding Levels
| Description | Construction Bonding Level (per contract) |
| Level | $0 |
| Description | Construction Bonding Level (aggregate) |
| Level | $0 |
| Description | Service Bonding Level (per contract) |
| Level | $0 |
| Description | Service Bonding Level (aggregate) |
| Level | $0 |
NAICS Codes with Size Determinations by NAICS
| Primary | Yes |
| Code | 621111 |
| NAICS Code's Description | Offices of Physicians (except Mental Health Specialists) |
| Buy Green | Yes |
Export Profile (Trade Mission Online)
| Exporter | No |
| Export Business Activities | (none given) |
| Exporting to | (none given) |
| Desired Export Business Relationships | (none given) |
| Description of Export Objective(s) | (none given) |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
