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SHAW MEDICAL GROUP LLC - Florida Company Profile

Company Details

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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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

National Provider Identifier

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

Contacts

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

Key Officers & Management

Name Role Address
SHAW MEDICAL GROUP LLC Othe -
SHAW PATRICK N Agent 947 Barefoot Blvd, Barefoot Bay, FL, 329767101

Events

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 -

Documents

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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1254147104 2020-04-10 0455 PPP 8000 Ron Beatty Blvd, Micco, FL, 32976-7438
Loan Status Date 2020-12-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 44622
Loan Approval Amount (current) 44622
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17616
Servicing Lender Name Seacoast National Bank
Servicing Lender Address 815 Colorado Ave, STUART, FL, 34994-3053
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Micco, BREVARD, FL, 32976-7438
Project Congressional District FL-08
Number of Employees 7
NAICS code 621112
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 124402
Originating Lender Name Seacoast National Bank
Originating Lender Address Melbourne, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 44866.18
Forgiveness Paid Date 2020-11-02
7133288402 2021-02-11 0455 PPS 8000 Ron Beatty Blvd, Micco, FL, 32976-7438
Loan Status Date 2021-11-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 44624
Loan Approval Amount (current) 44624
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17616
Servicing Lender Name Seacoast National Bank
Servicing Lender Address 815 Colorado Ave, STUART, FL, 34994-3053
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Micco, BREVARD, FL, 32976-7438
Project Congressional District FL-08
Number of Employees 8
NAICS code 621112
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 124402
Originating Lender Name Seacoast National Bank
Originating Lender Address Melbourne, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 44919.01
Forgiveness Paid Date 2021-10-08

U.S. Small Business Administration Profile

Status User ID Name of Firm Trade Name UEI Address
Active P2488697 SHAW MEDICAL GROUP LLC - VK2YB7NTQ483 947 BAREFOOT BLVD, BAREFOOT BAY, FL, 32976-7101
Capabilities Statement Link -
Phone Number 321-593-6999
Fax Number 321-327-2262
E-mail Address shawmedicalclinic@yahoo.com
WWW Page -
E-Commerce Website -
Contact Person PATRICK SHAW
County Code (3 digit) 009
Congressional District 08
Metropolitan Statistical Area 4900
CAGE Code 8NUL5
Year Established 2016
Accepts Government Credit Card Yes
Legal Structure LLC
Ownership and Self-Certifications Self-Certified Small Disadvantaged Business, Service-Disabled Veteran, Veteran
Business Development Servicing Office SOUTH FLORIDA DISTRICT OFFICE (SBA office code 0455)
Capabilities Narrative (none given)
Special Equipment/Materials (none given)
Business Type Percentages (none given)
Keywords Physician Office, Doctor, Primary Care, Laboratory, Covid-19 Testing, Check-up, Wellness, History & Physical, Walk-in Clinic, Urgent Care
Quality Assurance Standards (none given)
Electronic Data Interchange capable -

Current Principals

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