| Entity Name: | SUPERIOR CHOICE PHYSICIANS, INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 21 May 2019 (6 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Oct 2021 (3 years ago) |
| Document Number: | N19000005633 |
| FEI/EIN Number | 84-1878130 |
| Address: | 2519 McMullen Booth Road, Clearwater, FL, 33761, US |
| Mail Address: | 2519 McMullen Booth Road, Clearwater, FL, 33761, US |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902419187 | 2020-08-26 | 2022-04-19 | 2519 N MCMULLEN BOOTH RD STE 510-203, CLEARWATER, FL, 337614173, US | 2519 N MCMULLEN BOOTH RD STE 510-203, CLEARWATER, FL, 337614173, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 407-923-4205 |
Authorized person
| Name | DAVID DEJESUS |
| Role | CEO |
| Phone | 8177511811 |
Taxonomy
| Taxonomy Code | 163WH0200X - Home Health Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207QG0300X - Geriatric Medicine (Family Medicine) Physician |
| Is Primary | Yes |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2251G0304X - Geriatric Physical Therapist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Castle III Robert M | Agent | 201 S. Biscayne Boulevard, Miami, FL, 331314325 |
| Name | Role | Address |
|---|---|---|
| DEJESUS DAVID | Treasurer | 4851 MERLOT AVE, GRAPEVINE, TX, 76051 |
| Name | Role | Address |
|---|---|---|
| DEJESUS DAVID | President | 4851 MERLOT AVE, GRAPEVINE, TX, 76051 |
| Name | Role | Address |
|---|---|---|
| DEJESUS DAVID | Director | 4851 MERLOT AVE, GRAPEVINE, TX, 76051 |
| CATES PHILLIP | Director | 4851 MERLOT AVE, GRAPEVINE, TX, 76051 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2021-10-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-07 | 2519 McMullen Booth Road, 510-203, Clearwater, FL 33761 | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-07 | 2519 McMullen Booth Road, 510-203, Clearwater, FL 33761 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-10-07 | Castle III, Robert M. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-10-07 | 201 S. Biscayne Boulevard, 3400, Miami, FL 33131-4325 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-03-10 |
| REINSTATEMENT | 2021-10-07 |
| ANNUAL REPORT | 2020-06-30 |
| Domestic Non-Profit | 2019-05-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
