| Entity Name: | SOUTHLAND SELECT HOSPITALIST GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jan 2014 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Jan 2024 (a year ago) |
| Document Number: | M14000000238 |
| FEI/EIN Number | 46-4011412 |
| Address: | 100 S MADISON ST, THOMASVILLE, GA, 31792 |
| Mail Address: | 100 S MADISON ST, THOMASVILLE, GA, 31792 |
| Place of Formation: | GEORGIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821427246 | 2013-11-06 | 2013-11-06 | PO BOX 102545, ATLANTA, GA, 303682545, US | 1554 SURGEONS DR, TALLAHASSEE, FL, 323084631, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 850-219-6950 |
Authorized person
| Name | MARK ALLEN LEE |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 2292004019 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Henry Russell DEsq. | Agent | 1 Independent Drive, Jacksonville, FL, 32202 |
| Name | Role | Address |
|---|---|---|
| LEE M. ALLEN | Manager | PO BOX 1276, THOMASVILLE, GA, 31799 |
| WILLIAMS JONATHAN S | Manager | PO BOX 1276, THOMASVILLE, GA, 31799 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-01-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-03 | Henry, Russell D, Esq. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-03 | 1 Independent Drive, Suite 3130, Jacksonville, FL 32202 | No data |
| REVOKED FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-01-03 |
| Foreign Limited | 2014-01-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
