| Entity Name: | QUINCY FAMILY MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
QUINCY FAMILY MEDICINE, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 02 May 2000 (25 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 29 Aug 2008 (17 years ago) |
| Document Number: | P00000044516 |
| FEI/EIN Number |
593643388
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 10143 Moccasin Gap Road, Tallahassee, FL, 32309, US |
| Mail Address: | POB 13621, Tallahassee, FL, 32317, US |
| ZIP code: | 32309 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386812915 | 2008-02-17 | 2009-02-17 | 300 E JEFFERSON ST, QUINCY, FL, 323512530, US | 300 E JEFFERSON ST, QUINCY, FL, 323512530, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-875-1146 |
| Fax | 8508751218 |
Authorized person
| Name | DR. CARLA MONICA HOLLOMAN |
| Role | PHYSICIAN/OWNER |
| Phone | 8508751146 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS 0007688 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE GROUP |
| Number | K1831 |
| State | FL |
| Issuer | HEALTHEASE |
| Number | 167177 |
| State | FL |
| Issuer | MEDICAID |
| Number | 255092000 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 44300 |
| State | FL |
| Issuer | VISTA HEALTHPLAN |
| Number | 069578 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HOLLOMAN CARLA M | President | POB 13621, Tallahassee, FL, 32317 |
| HOLLOMAN CARLA M | Agent | 10143 Moccasin Gap Road, Tallahassee, FL, 32309 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-30 | 10143 Moccasin Gap Road, Tallahassee, FL 32309 | - |
| CHANGE OF MAILING ADDRESS | 2022-04-30 | 10143 Moccasin Gap Road, Tallahassee, FL 32309 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-30 | 10143 Moccasin Gap Road, Tallahassee, FL 32309 | - |
| CANCEL ADM DISS/REV | 2008-08-29 | - | - |
| REGISTERED AGENT NAME CHANGED | 2008-08-29 | HOLLOMAN, CARLA MD.O. | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2002-10-04 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-07 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-08 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
