BAPTIST PULMONARY SPECIALISTS, INC. - Florida Company Profile

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Company Details

Entity Name:	BAPTIST PULMONARY SPECIALISTS, INC.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Active
Date Filed:	12 Feb 2009 (16 years ago)
Document Number:	P09000014133
FEI/EIN Number	800351279
Mail Address:	841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207, US
Address:	3563 PHILIPS HIGHWAY, BUILDING A, SUITE 101, JACKSONVILLE, FL, 32207, US
ZIP code:	32207
City:	Jacksonville
County:	Duval
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
Groover, MD Timothy	Director	841 PRUDENTIAL DRIVE, SUITE 1601, JACKSONVILLE, FL, 32207
Baity G. S	Secretary	841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207
Tickell Keith	Vice President	841 Prudential Drive, Jacksonville, FL, 32207
MAYO MICHAEL A	President	841 Prudential Dr., 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., SUITE 1802, JACKSONVILLE, FL, 32207

National Provider Identifier

NPI Number:

1689817405

Certification Date:

2021-03-03

Link:

View on NPI website

Authorized Person:

Name:

CATHERINE HOLLOWAY

Role:

DIRECTOR

Phone:

9042025378

Taxonomy:

Selected Taxonomy:

207RS0010X - Sports Medicine (Internal Medicine) Physician

Is Primary:

Selected Taxonomy:

207RS0012X - Sleep Medicine (Internal Medicine) Physician

Is Primary:

Selected Taxonomy:

207RC0200X - Critical Care Medicine (Internal Medicine) Physician

Is Primary:

Selected Taxonomy:

207RP1001X - Pulmonary Disease Physician

Is Primary:

Yes

Contacts:

Phone:

+1 904-202-1032

Fax:

9043764107

Phone:

+1 904-376-3707

Fax:

9043915001

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G24000041698	BAPTIST MEDICAL GROUP	ACTIVE	2024-03-25	2029-12-31	-	3563 PHILIPS HIGHWAY, BLDG A, STE 101, JACKSONVILLE, FL, 32207
G24000034140	BAPTIST PULMONARY	ACTIVE	2024-03-06	2029-12-31	-	3563 PHILIPS HIGHWAY, BUILDING A, SUITE 101, JACKSONVILLE, FL, 32207

Events

Event Type	Filed Date	Value	Description
REGISTERED AGENT NAME CHANGED	2019-04-30	Baity, G. Scott	-
CHANGE OF PRINCIPAL ADDRESS	2010-04-30	3563 PHILIPS HIGHWAY, BUILDING A, SUITE 101, JACKSONVILLE, FL 32207	-
CHANGE OF MAILING ADDRESS	2010-04-30	3563 PHILIPS HIGHWAY, BUILDING A, SUITE 101, JACKSONVILLE, FL 32207	-
REGISTERED AGENT ADDRESS CHANGED	2009-11-06	841 PRUDENTIAL DR., SUITE 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	2020-06-29
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: 02 Aug 2025

Sources: Florida Department of State