| Entity Name: | SOUTHEAST ASSOCIATION OF HEALTHCARE PROVIDERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Dec 2000 (24 years ago) |
| Last Event: | AMENDED AND RESTATEDARTICLES/NAME CHANGE |
| Event Date Filed: | 23 Dec 2005 (19 years ago) |
| Document Number: | P00000112482 |
| FEI/EIN Number | 562551854 |
| Address: | 5330 N. DAVIS HWY, PENSACOLA, FL, 32503 |
| Mail Address: | 5330 N. DAVIS HWY, PENSACOLA, FL, 32503 |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942344106 | 2007-02-19 | 2020-02-20 | 5330 N DAVIS HWY, PENSACOLA, FL, 325032006, US | 5330 N DAVIS HWY, PENSACOLA, FL, 325032006, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-477-8874 |
| Fax | 8504778865 |
Authorized person
| Name | PHILIP E. RENFROE |
| Role | PRESIDENT |
| Phone | 8504778874 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6343 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6348 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8124 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME92143 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT4977 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS GROUP NO. |
| Number | 99322 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RENFROE PHILIP E | Agent | 5330 N. DAVIS HWY, PENSACOLA, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| RENFROE PHILIP E | President | 5330 N. DAVIS HWY, PENSACOLA, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| RENFROE PHILIP E | Director | 5330 N. DAVIS HWY, PENSACOLA, FL, 32503 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000092136 | RETURN TO HEALTH MEDICAL HOME AND WELLNESS CENTER | ACTIVE | 2011-09-19 | 2026-12-31 | No data | 5330 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503, US |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-28 | 5330 N. DAVIS HWY, PENSACOLA, FL 32503 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-28 | 5330 N. DAVIS HWY, PENSACOLA, FL 32503 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-28 | 5330 N. DAVIS HWY, PENSACOLA, FL 32503 | No data |
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 2005-12-23 | SOUTHEAST ASSOCIATION OF HEALTHCARE PROVIDERS, INC. | No data |
| REGISTERED AGENT NAME CHANGED | 2005-12-23 | RENFROE, PHILIP E | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000273662 | TERMINATED | 1000000991081 | ESCAMBIA | 2024-04-30 | 2034-05-08 | $ 1,328.18 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, PENSACOLA SERVICE CENTER, 2205 LA VISTA AVE STE B, PENSACOLA FL325048210 |
| J13000761768 | TERMINATED | 1000000489512 | ESCAMBIA | 2013-04-11 | 2023-04-17 | $ 1,664.68 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, PENSACOLA SERVICE CENTER, 3670 N L ST STE C, PENSACOLA FL325055254 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-03-24 |
| ANNUAL REPORT | 2020-03-16 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-12 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
