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BAPTIST NEUROLOGY, INC. - Florida Company Profile

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Company Details

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
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Groover Timothy MD Director 841 PRUDENTIAL DRIVE, SUITE 1601, JACKSONVILLE, FL, 32207
Baity G. S Secretary 841 Prudential Drive, Jacksonville, FL, 32207
Tickell Keith Treasurer 841 Prudential Drive, Jacksonville, FL, 32207
MAYO MICHAEL MD President 841 Prudential Ave., Jacksonville, FL, 32207
ZUINO MATTHEW A Director 841 Prudential Dr., Jacksonville, FL, 32207
Gorak Edward DO Vice President 841 Prudential Dr., Jacksonville, FL, 32207
Baity G. S Agent 841 PRUDENTIAL DR STE 1802, JACKSONVILLE, FL, 32207

National Provider Identifier

NPI Number:
1588285126
Certification Date:
2020-05-06

Authorized Person:

Name:
JASON R KIMBALL
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
2084N0400X - Neurology Physician
Is Primary:
Yes

Contacts:

Fax:
9043915595
Fax:
9047303688

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000041696 BAPTIST MEDICAL GROUP ACTIVE 2024-03-25 2029-12-31 - 841 PRUDENTIAL DRIVE, SUITE 1410, JACKSONVILLE, FL, 32207
G22000096119 BAPTIST NEUROLOGY GROUP ACTIVE 2022-08-15 2027-12-31 - 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207
G10000044942 BAPTIST NEUROLOGY GROUP EXPIRED 2010-05-21 2015-12-31 - 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2022-08-17 841 Prudential Drive, Suite 1410, JACKSONVILLE, FL 32207 -
CHANGE OF PRINCIPAL ADDRESS 2020-06-16 841 Prudential Drive, Suite 1410, JACKSONVILLE, FL 32207 -
REGISTERED AGENT NAME CHANGED 2019-04-30 Baity, G. Scott -
REGISTERED AGENT ADDRESS CHANGED 2009-11-16 841 PRUDENTIAL DR STE 1802, JACKSONVILLE, FL 32207 -

Documents

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

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Date of last update: 01 Aug 2025

Sources: Florida Department of State