| Entity Name: | BAPTIST NEUROLOGY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 May 2008 (17 years ago) |
| Document Number: | P08000051072 |
| FEI/EIN Number | 262665620 |
| Mail Address: | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207, US |
| Address: | 841 Prudential Drive, Suite 1410, JACKSONVILLE, FL, 32207, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588285126 | 2020-05-06 | 2020-05-06 | PO BOX 41113, JACKSONVILLE, FL, 322031113, US | 7807 BAYMEADOWS RD E STE 401, JACKSONVILLE, FL, 322569668, US | |||||||||||||||||||
|
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| Phone | +1 904-376-4400 |
| Fax | 9043915595 |
| Phone | +1 904-730-3689 |
| Fax | 9047303688 |
Authorized person
| Name | JASON R KIMBALL |
| Role | DIRECTOR |
| Phone | 9042026295 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Agent | 841 PRUDENTIAL DR STE 1802, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Groover Timothy MD | Director | 841 PRUDENTIAL DRIVE, SUITE 1601, JACKSONVILLE, FL, 32207 |
| ZUINO MATTHEW A | Director | 841 Prudential Dr., Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Secretary | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Tickell Keith | Treasurer | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| MAYO MICHAEL MD | President | 841 Prudential Ave., Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Gorak Edward DO | Vice President | 841 Prudential Dr., Jacksonville, FL, 32207 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000041696 | BAPTIST MEDICAL GROUP | ACTIVE | 2024-03-25 | 2029-12-31 | No data | 841 PRUDENTIAL DRIVE, SUITE 1410, JACKSONVILLE, FL, 32207 |
| G22000096119 | BAPTIST NEUROLOGY GROUP | ACTIVE | 2022-08-15 | 2027-12-31 | No data | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207 |
| G10000044942 | BAPTIST NEUROLOGY GROUP | EXPIRED | 2010-05-21 | 2015-12-31 | No data | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-08-17 | 841 Prudential Drive, Suite 1410, JACKSONVILLE, FL 32207 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-16 | 841 Prudential Drive, Suite 1410, JACKSONVILLE, FL 32207 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-04-30 | Baity, G. Scott | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-11-16 | 841 PRUDENTIAL DR STE 1802, JACKSONVILLE, FL 32207 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-16 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
