| Entity Name: | JUPITER PRIMARY CARE GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Mar 2007 (18 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P07000032151 |
| FEI/EIN Number | 208629208 |
| Address: | 210 JUPITER LAKES BLVD., 4000-SUITE 104, JUPITER, FL, 33458, US |
| Mail Address: | 210 JUPITER LAKES BLVD., 4000-SUITE 104, JUPITER, FL, 33458, US |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619178001 | 2007-05-31 | 2020-08-22 | 210 JUPITER LAKES BLVD, BUILDING 4000 SUITE 105, JUPITER, FL, 334587191, US | 210 JUPITER LAKES BLVD, BUILDING 4000 SUITE 105, JUPITER, FL, 334587191, US | |||||||||||||||
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| Phone | +1 561-743-9077 |
| Fax | 5617456529 |
Authorized person
| Name | MICHELLE FATIMA FULLER |
| Role | OFFICE MANAGER |
| Phone | 5616292990 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KLEIN BRENT D | Agent | SUITE 1900, 701 BRICKELL AVE, MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| SYED BAQIR | Director | SUITE 111 9121 NORTH MILITARY TRAIL, PALM BEACH GARDENS, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-11 | 210 JUPITER LAKES BLVD., 4000-SUITE 104, JUPITER, FL 33458 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-11 | 210 JUPITER LAKES BLVD., 4000-SUITE 104, JUPITER, FL 33458 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-01-22 |
| ANNUAL REPORT | 2014-01-11 |
| ANNUAL REPORT | 2013-01-17 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-03-10 |
| ANNUAL REPORT | 2010-01-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
