| Entity Name: | EVEREST MEDICAL CARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Mar 2006 (19 years ago) |
| Document Number: | P06000043446 |
| FEI/EIN Number | 204680164 |
| Address: | 4296 5TH AVENUE, MARIANNA, FL, 32446 |
| Mail Address: | 4296 5TH AVENUE, MARIANNA, FL, 32446 |
| ZIP code: | 32446 |
| County: | Jackson |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033174594 | 2006-04-19 | 2013-12-12 | 4296 5TH AVE, MARIANNA, FL, 324462173, US | 4296 5TH AVE, MARIANNA, FL, 324462173, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-482-2061 |
| Fax | 8504826617 |
Authorized person
| Name | MS. MARGARET M CARTER |
| Role | OFFICE MANAGER |
| Phone | 8504822061 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME77246 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| License Number | ME77246 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME77246 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| License Number | ME77246 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME27861 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| License Number | PA9101074 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| License Number | ARNP3033052 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| License Number | ARNP1903302 |
| State | FL |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EVEREST MEDICAL CARE, P.A. 401(K) PLAN | 2019 | 204680164 | 2020-10-13 | EVEREST MEDICAL CARE, P.A. | 15 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2020-10-13 |
| Name of individual signing | MARGARET CARTER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8504822061 |
| Plan sponsor’s address | 4296 5TH AVENUE, MARIANNA, FL, 32446 |
Signature of
| Role | Plan administrator |
| Date | 2018-06-11 |
| Name of individual signing | MARGARET CARTER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CHINTANADILOK SUTTHANOM | Agent | 2402 NW27TH TER, GAINESVILLE, FL, 32605 |
| Name | Role | Address |
|---|---|---|
| CHINTANADILOK JIRAYOS M | Director | 4296 5TH AVENUE, MARIANNA, FL, 32446 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-05-01 | 4296 5TH AVENUE, MARIANNA, FL 32446 | No data |
| CHANGE OF MAILING ADDRESS | 2025-05-01 | 4296 5TH AVENUE, MARIANNA, FL 32446 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-09-06 | CHINTANADILOK, SUTTHANOM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-06 | 2402 NW27TH TER, GAINESVILLE, FL 32605 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-09-06 |
| ANNUAL REPORT | 2021-09-08 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-02-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
