| Entity Name: | MERCY MEDICAL DEVELOPMENT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 24 May 1985 (40 years ago) |
| Date of dissolution: | 27 Jun 2014 (11 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 27 Jun 2014 (11 years ago) |
| Document Number: | N09556 |
| FEI/EIN Number |
592789194
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308, US |
| Mail Address: | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308, US |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992787576 | 2005-11-18 | 2008-05-29 | PO BOX 331966, MIAMI, FL, 332331966, US | 3641 S MIAMI AVE, MIAMI, FL, 331334205, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-860-4660 |
| Fax | 3058604682 |
Authorized person
| Name | MR. JERRY MASHBURN |
| Role | CFO |
| Phone | 3058544400 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207UN0901X - Nuclear Cardiology Physician |
| Is Primary | No |
| Taxonomy Code | 207ZP0102X - Anatomic Pathology & Clinical Pathology Physician |
| Is Primary | No |
| Taxonomy Code | 2085N0904X - Nuclear Radiology Physician |
| Is Primary | No |
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 2085R0203X - Therapeutic Radiology Physician |
| Is Primary | No |
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| Is Primary | No |
| Taxonomy Code | 2085U0001X - Diagnostic Ultrasound Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 060942100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WATTS HOWARD | Chairman | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308 |
| WATTS HOWARD | Director | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308 |
| WILFORD LINDA V | Treasurer | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308 |
| WILFORD LINDA V | Director | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308 |
| WORLEY, SSJ SR. ELIZABETH | Secretary | 9401 BISCAYNE BLVD., MIAMI SHORES, FL, 33138 |
| WORLEY, SSJ SR. ELIZABETH | Director | 9401 BISCAYNE BLVD., MIAMI SHORES, FL, 33138 |
| FITZGERALD J P | Director | 110 MERRICK WAY, SUITE 3B, CORAL GABLES, FL, 33131 |
| MARIN TOMAS M | Director | 5400 SW 102 AVE, MIAMI, FL, 33165 |
| Stoecker, SSJ Jane | Director | 241 St. George Street, St. Augustine, FL, 32085 |
| WEBBER DALE S | Agent | 401 E. JACKSON ST., STE. 2500, TAMPA, FL, 33602 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08039700034 | MERCY LABORATORY ASSOCIATES | EXPIRED | 2008-02-08 | 2013-12-31 | - | 3663 SOUTH MIAMI AVE, MIAMI, FL, 33133 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2014-06-27 | - | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS 705193. MERGER NUMBER 300000141763 |
| AMENDMENT | 2011-07-19 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2011-07-19 | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308 | - |
| CHANGE OF MAILING ADDRESS | 2011-07-19 | 4725 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308 | - |
| REGISTERED AGENT NAME CHANGED | 2011-07-19 | WEBBER, DALE S | - |
| REGISTERED AGENT ADDRESS CHANGED | 2011-07-19 | 401 E. JACKSON ST., STE. 2500, TAMPA, FL 33602 | - |
| AMENDED AND RESTATEDARTICLES | 2003-11-21 | - | - |
| AMENDED AND RESTATEDARTICLES | 2003-04-11 | - | - |
| AMENDMENT | 2002-12-16 | - | - |
| AMENDED AND RESTATEDARTICLES | 1999-02-01 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-03-04 |
| ANNUAL REPORT | 2013-03-27 |
| ANNUAL REPORT | 2012-02-01 |
| Amendment | 2011-07-19 |
| ANNUAL REPORT | 2011-02-28 |
| ANNUAL REPORT | 2010-03-04 |
| ANNUAL REPORT | 2009-02-13 |
| ANNUAL REPORT | 2008-02-04 |
| ANNUAL REPORT | 2007-02-23 |
| ANNUAL REPORT | 2006-01-31 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
