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PHYSICIAN GROUP HOLDINGS, LLC - Florida Company Profile

Company Details

Entity Name: PHYSICIAN GROUP HOLDINGS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

PHYSICIAN GROUP HOLDINGS, 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: 07 Aug 2018 (7 years ago)
Document Number: L18000188484
FEI/EIN Number 83-1512090

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1375 MARSH HARBOR DRIVE, JACKSONVILLE, FL, 32225, US
Mail Address: 1375 MARSH HARBOR DRIVE, JACKSONVILLE, FL, 32225, US
ZIP code: 32225
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003478827 2019-07-01 2019-07-01 10210 SAN JOSE BLVD STE 4, JACKSONVILLE, FL, 322576271, US 10210 SAN JOSE BLVD STE 4, JACKSONVILLE, FL, 322576271, US

Contacts

Phone +1 904-990-8484
Fax 9049908485

Authorized person

Name DR. MEGAN ELIZABETH DEACON-CASEY
Role MEDICAL DIRECTOR
Phone 9049908484

Taxonomy

Taxonomy Code 2085R0204X - Vascular & Interventional Radiology Physician
Is Primary Yes

Key Officers & Management

Name Role Address
DEACON-CASEY MEGAN E Manager 1375 MARSH HARBOR DRIVE, JACKSONVILLE, FL, 32225
BOWEN-WELLS CAROL P Manager 6420 San Juan Avenue, JACKSONVILLE, FL, 32210
CASEY HUGH Agent 1375 MARSH HARBOR DRIVE, JACKSONVILLE, FL, 32225

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000073004 AGELESS VEIN CENTER EXPIRED 2019-07-01 2024-12-31 - 10210 SAN JOSE BLVD, JACKSONVILLE, FL, 32257
G18000099613 AGELESS REJUVENATION CENTER EXPIRED 2018-09-08 2023-12-31 - 1375 MARSH HARBOR DRIVE, JACKSONVILLE, FL, 32225

Documents

Name Date
ANNUAL REPORT 2024-04-29
ANNUAL REPORT 2023-04-30
ANNUAL REPORT 2022-04-29
ANNUAL REPORT 2021-04-26
ANNUAL REPORT 2020-06-06
ANNUAL REPORT 2019-04-25
Florida Limited Liability 2018-08-07

Date of last update: 02 Apr 2025

Sources: Florida Department of State