| Entity Name: | DOUGLAS M TEW MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Dec 2018 (6 years ago) |
| Document Number: | L18000288892 |
| FEI/EIN Number | 83-2642606 |
| Address: | 2301 PARK AVE, 209, ORANGE PARK, FL, 32073 |
| Mail Address: | 3527 WESTOVER ROAD, FLEMING ISLAND, FL, 32003 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114482494 | 2019-01-31 | 2019-01-31 | 2301 PARK AVE STE 209, ORANGE PARK, FL, 320735558, US | 2 PAVILION PLACE, PENNEY FARMS, FL, 32079, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 904-945-1224 |
Authorized person
| Name | DR. DOUGLAS M TEW |
| Role | OWNER |
| Phone | 9049451224 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NICHOLS GROUP PA | Agent | 1635 EAGLE HARBOR PKWY, FLEMING ISLAND, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| TEW DOUGLAS MMD | Manager | 3527 WESTOVER ROAD, FLEMING ISLAND, FL, 32003 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-02-24 |
| ANNUAL REPORT | 2021-04-18 |
| ANNUAL REPORT | 2020-04-04 |
| Florida Limited Liability | 2018-12-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
