| Entity Name: | KEY WEST MEDICAL GROUP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
KEY WEST MEDICAL GROUP, P.A. 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 26 Sep 2001 (24 years ago) |
| Date of dissolution: | 19 Nov 2015 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Nov 2015 (9 years ago) |
| Document Number: | P01000094940 |
| FEI/EIN Number |
651140859
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1111 12TH ST,, SUITE 210, KEY WEST, FL, 33040 |
| Mail Address: | 1404 Petronia Street, KEY WEST, FL, 33040, US |
| ZIP code: | 33040 |
| County: | Monroe |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477605285 | 2007-01-18 | 2011-02-11 | 1111 12TH ST, SUITE210, KEY WEST, FL, 330404088, US | 1111 12TH ST, SUITE210, KEY WEST, FL, 330404088, US | |||||||||||||||||||
|
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| Phone | +1 305-296-2414 |
Authorized person
| Name | MS. LISA LACOVA |
| Role | BILLING MANAGER |
| Phone | 9544261186 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 067849000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CALLEJA JOHN F | President | 1111 12TH ST, SUITE 210, KEY WEST, FL, 33040 |
| CALLEJA JOHN F | Agent | 1404 Petronia Street, KEY WEST, FL, 33040 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-11-19 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-27 | 1404 Petronia Street, KEY WEST, FL 33040 | - |
| CHANGE OF MAILING ADDRESS | 2015-03-27 | 1111 12TH ST,, SUITE 210, KEY WEST, FL 33040 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-06 | 1111 12TH ST,, SUITE 210, KEY WEST, FL 33040 | - |
| REGISTERED AGENT NAME CHANGED | 2012-01-06 | CALLEJA, JOHN F | - |
| CANCEL ADM DISS/REV | 2007-09-12 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | - | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-11-19 |
| ANNUAL REPORT | 2015-03-27 |
| ANNUAL REPORT | 2014-01-14 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-03-16 |
| ANNUAL REPORT | 2010-04-23 |
| ANNUAL REPORT | 2009-03-26 |
| ANNUAL REPORT | 2008-05-30 |
| REINSTATEMENT | 2007-09-12 |
Date of last update: 01 May 2025
Sources: Florida Department of State
