| Entity Name: | QUANTUM GENESIS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Jun 2004 (21 years ago) |
| Document Number: | P04000097470 |
| FEI/EIN Number | 141909186 |
| Address: | 3165 MCMULLEN BOOTH RD - STE H, CLEARWATER, FL, 33761 |
| Mail Address: | 3165 MCMULLEN BOOTH RD - STE H, CLEARWATER, FL, 33761, US |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285631416 | 2005-07-01 | 2016-10-13 | 3165 N MCMULLEN BOOTH RD, SUITE H, CLEARWATER, FL, 337612032, US | 3165 N MCMULLEN BOOTH RD, SUITE H, CLEARWATER, FL, 337612032, US | |||||||||||||||||||
|
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| Phone | +1 727-787-3911 |
| Fax | 7277862272 |
Authorized person
| Name | DR. DAVID L HICKS |
| Role | PHYSICIAN/CEO |
| Phone | 7277873911 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS4796 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HICKS DAVID L | Agent | 835 LAKESIDE TERRACE, PALM HARBOR, FL, 34683 |
| Name | Role | Address |
|---|---|---|
| HICKS DAVID L | President | 835 LAKESIDE TERRACE, PALM HARBOR, FL, 34683 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G04272700036 | WEST COAST FAMILY MEDICAL CARE | ACTIVE | 2004-09-28 | 2029-12-31 | No data | 3165 MCMULLEN BOOTH RD, STE H, CLEARWATER, FL, 33761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2013-04-23 | 3165 MCMULLEN BOOTH RD - STE H, CLEARWATER, FL 33761 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-21 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-02-26 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-02-08 |
| ANNUAL REPORT | 2015-02-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
