| Entity Name: | QUALITY PATHOLOGY GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Jul 2006 (19 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 11 Jan 2010 (15 years ago) |
| Document Number: | P06000092227 |
| FEI/EIN Number | 205291711 |
| Address: | 15 HARBOUR ISLE DRIVE W., UNIT 203, FORT PIERCE, FL, 34949, US |
| Mail Address: | 15 HARBOUR ISLE DRIVE W., UNIT 203, FORT PIERCE, FL, 34949, US |
| ZIP code: | 34949 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972661817 | 2006-12-04 | 2010-01-29 | PO BOX 63069, N CHARLESTON, SC, 29406, US | 5361 NW 33 AVENUE, FORT LAUDERDALE, FL, 33309, US | |||||||||||||||||||||||||||||
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| Phone | +1 305-229-4311 |
| Fax | 3052294388 |
| Phone | +1 954-717-0299 |
Authorized person
| Name | MARCELINO ALVAREZ |
| Role | PRESIDENT |
| Phone | 9547170299 |
Taxonomy
| Taxonomy Code | 207ZP0102X - Anatomic Pathology & Clinical Pathology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 99366 |
| State | FL |
| Issuer | MEDICAID |
| Number | 277571900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Alvarez Marcelino Dr. | Agent | 15 Harbour Isle Drive West, Fort Pierce, FL, 349492767 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ MARCELINO LDr. | Director | 15 HARBOUR ISLE DRIVE W., UNIT 203, FORT PIERCE, FL, 34949 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2018-01-27 | Alvarez, Marcelino, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-27 | 15 Harbour Isle Drive West, No. 203, Fort Pierce, FL 34949-2767 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-13 | 15 HARBOUR ISLE DRIVE W., UNIT 203, FORT PIERCE, FL 34949 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-13 | 15 HARBOUR ISLE DRIVE W., UNIT 203, FORT PIERCE, FL 34949 | No data |
| CANCEL ADM DISS/REV | 2010-01-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-02-26 |
| ANNUAL REPORT | 2021-02-14 |
| ANNUAL REPORT | 2020-01-25 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-27 |
| ANNUAL REPORT | 2017-02-25 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-01-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
