| Entity Name: | PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Nov 2004 (20 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 11 Mar 2016 (9 years ago) |
| Document Number: | P04000153630 |
| FEI/EIN Number | 562498335 |
| Address: | 1980-1990 N PROSPECT AVE, LECANTO, FL, 34461, US |
| Mail Address: | 1980-1990 N PROSPECT AVE, LECANTO, FL, 34461, US |
| ZIP code: | 34461 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659056117 | 2023-06-21 | 2024-02-01 | PO BOX 2066, LECANTO, FL, 344602066, US | 2385 N LECANTO HWY, LECANTO, FL, 344619677, US | |||||||||||||||||||||||
|
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| Phone | +1 352-684-8736 |
| Phone | +1 352-527-6888 |
Authorized person
| Name | DEAN C MAJOR |
| Role | CRED SPEC |
| Phone | 3526348736 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| THE PERMENTER LAW FIRM, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| ST MARTIN DACELIN MD | President | PO BOX 2066, LECANTO, FL, 34460 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000098794 | SLEEP CLINIC OF AMERICA | ACTIVE | 2023-08-23 | 2028-12-31 | No data | 1990 N PROSPECT AVE, LECANTO, FL, 34461 |
| G23000098805 | MHST | ACTIVE | 2023-08-23 | 2028-12-31 | No data | 1990 N PROSPECT AVE, LECANTO, FL, 34461 |
| G22000146818 | PEDIM HEALTHCARE | ACTIVE | 2022-11-29 | 2027-12-31 | No data | 1990 N PROSPECT AVE, LECANTO, FL, 34461 |
| G17000011066 | MY HOME SLEEP TESTING | EXPIRED | 2017-01-30 | 2022-12-31 | No data | PO BOX 2066, LECANTO, FL, 34461 |
| G14000086835 | PEDIM IMAGING CENTER | EXPIRED | 2014-08-23 | 2024-12-31 | No data | PRO BOX 2066, LECANTO, FL, 34460 |
| G14000086834 | PEDIM LABORATORY | EXPIRED | 2014-08-23 | 2024-12-31 | No data | PO BOX 2066, LECANTO, FL, 34460 |
| G12000097813 | PEDIM HEALTHCARE | EXPIRED | 2012-10-05 | 2017-12-31 | No data | PO BOX 2066, LECANTO, FL, 34460 |
| G12000097229 | THE NEW IMAGE HOLISTIC WELLNESS & MEDSPA | EXPIRED | 2012-10-04 | 2017-12-31 | No data | PO BOX 2066, LECANTO, FL, 34460 |
| G10000013930 | QUICK CARE MED | EXPIRED | 2010-02-12 | 2015-12-31 | No data | P.O. BOX 2066, LECANTO, FL, 34460 |
| G10000013931 | SLEEP CLINIC OF AMERICA | EXPIRED | 2010-02-12 | 2015-12-31 | No data | P.O. BOX 2066, LECANTO, FL, 34460 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-04 | 1980-1990 N PROSPECT AVE, LECANTO, FL 34461 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-04 | 1980-1990 N PROSPECT AVE, LECANTO, FL 34461 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-22 | 2201 S.E. 30th Avenue, Suite 202, Ocala, FL 34471 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-22 | The Permenter Law Firm, P.A. | No data |
| AMENDMENT | 2016-03-11 | No data | No data |
| AMENDMENT AND NAME CHANGE | 2015-12-28 | PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS, INC. | No data |
| NAME CHANGE AMENDMENT | 2005-10-03 | PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS, PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-04-22 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-24 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-04-26 |
| Reg. Agent Change | 2018-12-27 |
| ANNUAL REPORT | 2018-01-02 |
| ANNUAL REPORT | 2017-01-11 |
| Amendment | 2016-03-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
