| Entity Name: | BETHESDA HEALTH PHYSICIAN GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 04 Jan 1995 (30 years ago) |
| Last Event: | AMENDED AND RESTATED ARTICLES |
| Event Date Filed: | 21 Sep 2017 (7 years ago) |
| Document Number: | N95000000069 |
| FEI/EIN Number | 650561267 |
| Address: | 2815 S SEACREST BLVD, BOYNTON BEACH, FL, 33435 |
| Mail Address: | 2815 S SEACREST BLVD, BOYNTON BEACH, FL, 33435 |
| ZIP code: | 33435 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699863936 | 2006-10-11 | 2014-02-18 | 2815 S SEACREST BLVD, ATTN: FINANCE, BOYNTON BEACH, FL, 334357934, US | 2815 S SEACREST BLVD, ATTN: FINANCE, BOYNTON BEACH, FL, 334357934, US | |||||||||||||||||||||
|
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| Phone | +1 561-737-7733 |
| Fax | 5617335912 |
Authorized person
| Name | MS. MARY JC PEED |
| Role | PROFESSIONAL ADMINISTRATOR |
| Phone | 5617377733 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2563126 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| SMITH JARED M | Chief Executive Officer | 2815 S SEACREST BLVD, BOYNTON BEACH, FL, 33435 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000041750 | BAPTIST HEALTH OBSTETRICS & GYNECOLOGY BOYNTON BEACH | ACTIVE | 2022-04-01 | 2027-12-31 | No data | 10301 HAGEN RANCH ROAD, SUITE B740, BOYNTON BEAH, FL, 33437 |
| G22000041760 | BAPTIST HEALTH MATERNAL-FETAL MEDICINE BOYNTON BEACH | ACTIVE | 2022-04-01 | 2027-12-31 | No data | 1325 S CONGRESS AVENUE, SUITE 103, BOYNTON BEACH, FL, 33426 |
| G19000067315 | BETHESDA COMMUNITY HEALTH CENTER | EXPIRED | 2019-06-13 | 2024-12-31 | No data | 2815 SOUTH SEACREST BOULEVARD, BOYNTON BEACH, FL, 33435 |
| G17000003634 | MATERNAL-FETAL MEDICINE OF THE PALM BEACHES | ACTIVE | 2017-01-10 | 2027-12-31 | No data | 2815 S. SEACREST BLVD, BOYNTON BEACH, FL, 33435 |
| G17000003637 | WOMEN FOR WOMEN | ACTIVE | 2017-01-10 | 2027-12-31 | No data | 2815 S. SEACREST BLVD., BOYNTON BEACH, FL, 33435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-07-23 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-07-23 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| AMENDED AND RESTATEDARTICLES | 2017-09-21 | No data | No data |
| AMENDMENT | 2015-12-21 | No data | No data |
| AMENDMENT | 2014-09-29 | No data | No data |
| NAME CHANGE AMENDMENT | 2013-11-21 | BETHESDA HEALTH PHYSICIAN GROUP, INC. | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-01 | 2815 S SEACREST BLVD, BOYNTON BEACH, FL 33435 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-01 | 2815 S SEACREST BLVD, BOYNTON BEACH, FL 33435 | No data |
| NAME CHANGE AMENDMENT | 1995-09-28 | BETHESDA MEDICAL ASSOCIATES, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-04-14 |
| ANNUAL REPORT | 2021-04-19 |
| Reg. Agent Change | 2020-07-23 |
| AMENDED ANNUAL REPORT | 2020-06-26 |
| AMENDED ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2020-02-13 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-03-09 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
