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. |
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 |
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 | |||||||||||||||
|
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 |
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 |
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 |
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