| Entity Name: | HEALTHPOINT MEDICAL GROUP OF THE EMERALD COAST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Jun 2017 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 Sep 2017 (7 years ago) |
| Document Number: | L17000122919 |
| FEI/EIN Number | 82-1797264 |
| Address: | 12234 PANAMA CITY BEACH PARKWAY, SUITE B, PANAMA CITY BEACH, FL 32407 |
| Mail Address: | 12234 PANAMA CITY BEACH PARKWAY, SUITE B, PANAMA CITY BEACH, FL 32407 |
| ZIP code: | 32407 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679097679 | 2017-08-01 | 2022-07-21 | 12234 PANAMA CITY BEACH PKWY STE C, PANAMA CITY BEACH, FL, 324072726, US | 12234 PANAMA CITY BEACH PKWY STE C, PANAMA CITY BEACH, FL, 324072726, US | |||||||||||||||||
|
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| Phone | +1 850-233-2323 |
Authorized person
| Name | DR. MICHAEL B HARRIS |
| Role | MGR |
| Phone | 8502332323 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | 58926Y |
| Name | Role | Address |
|---|---|---|
| HARRIS, MICHAEL | Agent | 12234 PANAMA CITY BEACH PARKWAY, SUITE B, PANAMA CITY BEACH, FL 32407 |
| Name | Role | Address |
|---|---|---|
| HARRIS, MICHAEL | Manager | 12234 PANAMA CITY BEACH PARKWAY, SUITE C, PANAMA CITY BEACH, FL 32407 |
| MCCLUNG, WILLIAM | Manager | 12234 PANAMA CITY BEACH PARKWAY, SUITE B PANAMA CITY BEACH, FL 32407 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2017-09-13 | No data | No data |
| LC STMNT OF RA/RO CHG | 2017-08-15 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-08-15 | 12234 PANAMA CITY BEACH PARKWAY, SUITE B, PANAMA CITY BEACH, FL 32407 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-08-07 | 12234 PANAMA CITY BEACH PARKWAY, SUITE B, PANAMA CITY BEACH, FL 32407 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-13 |
| ANNUAL REPORT | 2024-01-08 |
| ANNUAL REPORT | 2023-01-09 |
| ANNUAL REPORT | 2022-01-03 |
| ANNUAL REPORT | 2021-01-04 |
| ANNUAL REPORT | 2020-01-06 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-09 |
| LC Amendment | 2017-09-13 |
| CORLCRACHG | 2017-08-15 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
