| Entity Name: | MEDICAL STAFF OF PUTNAM COMMUNITY MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 04 Apr 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 22 Aug 2023 (a year ago) |
| Document Number: | N17000003624 |
| FEI/EIN Number | 82-1078642 |
| Address: | 611 ZEAGLER DR., PALATKA, FL, 32177, US |
| Mail Address: | Medical Staff of PCMC Inc.,Medical Staff O, HCA Florida Putnam Hospital, Palatka, FL, 32177, US |
| ZIP code: | 32177 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| Kuruvilla Anand MChief o | Agent | Medical Staff of PCMC, Inc, PALATKA, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| Salzman Christopher MD | Director | Medical Staff of PCMC Inc.,Medical Staff O, Palatka, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| Kuruvilla Anand MM.D. | President | Medical Staff of PCMC Inc.,Medical Staff O, Palatka, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| Miles Dawn SDPM | Treasurer | Medical Staff of PCMC Inc.,Medical Staff O, Palatka, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| FEIBELMAN RICHARD MD | Vice President | 611 ZEAGLER DR., PALATKA, FL, 32177 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-13 | Kuruvilla, Anand Mathai, Chief of Staff | No data |
| REINSTATEMENT | 2023-08-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2023-08-22 | 611 ZEAGLER DR., PALATKA, FL 32177 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-08-22 | Medical Staff of PCMC, Inc, HCA Fl Putnam Hospital, 611 ZEAGLER DR., Medical Staff Office, PALATKA, FL 32177 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 2019-10-31 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2024-01-04 |
| REINSTATEMENT | 2023-08-22 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-20 |
| Amended and Restated Articles | 2019-10-31 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-03-30 |
| Domestic Non-Profit | 2017-04-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
