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NORTH FLORIDA CANCER CENTER TALLAHASSEE, LLC - Florida Company Profile

Company Details

Entity Name: NORTH FLORIDA CANCER CENTER TALLAHASSEE, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
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 Jan 2005 (20 years ago)
Document Number: M05000000122
FEI/EIN Number 522448724

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

Address: ONE PARK PLAZA, NASHVILLE, TN, 37203, US
Mail Address: ONE PARK PLAZA, LEGAL DEPARTMENT, NASHVILLE, TN, 37203, US
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952398448 2005-09-30 2012-05-01 2003 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084893, US 2003 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084893, US

Contacts

Phone +1 850-878-2273
Fax 8506715900

Authorized person

Name JOAN R GLADNEY
Role REGIONAL DIRECTOR
Phone 3524746190

Taxonomy

Taxonomy Code 2085R0001X - Radiation Oncology Physician
Is Primary Yes

Other Provider Identifiers

Issuer BCBS OF FL
Number 21130
State FL
Issuer RR MEDICARE
Number DD1687
State FL
Issuer MEDICAID
Number 272084100
State FL

Key Officers & Management

Name Role Address
Foster Jon M Manager ONE PARK PLAZA, NASHVILLE, TN, 37203
Hazen Samuel N Manager One Park Plaza, Nashville, TN, 37203
Wyatt Christopher F Manager One Park Plaza, Nashville, TN, 37203
C T CORPORATION SYSTEM Agent -

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000001231 CAPITAL REGIONAL CANCER CENTER ACTIVE 2010-01-05 2025-12-31 - ONE PARK PLAZA, LEGAL DEPARTMENT, NASHVILLE, TN, 37203
G06186900003 CAPITAL CANCER CENTER ACTIVE 2006-07-05 2026-12-31 - ONE PARK PLAZA, LEGAL DEPARTMENT, NASHVILLE, TN, 37203

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2011-08-11 ONE PARK PLAZA, NASHVILLE, TN 37203 -
CHANGE OF PRINCIPAL ADDRESS 2006-04-24 ONE PARK PLAZA, NASHVILLE, TN 37203 -

Documents

Name Date
ANNUAL REPORT 2024-04-16
ANNUAL REPORT 2023-04-18
ANNUAL REPORT 2022-04-22
ANNUAL REPORT 2021-04-26
ANNUAL REPORT 2020-04-29
ANNUAL REPORT 2019-04-18
ANNUAL REPORT 2018-04-17
ANNUAL REPORT 2017-04-21
ANNUAL REPORT 2016-04-22
ANNUAL REPORT 2015-04-21

Date of last update: 01 Apr 2025

Sources: Florida Department of State