| Entity Name: | P3 MEDICAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Aug 2009 (16 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 03 Jun 2016 (9 years ago) |
| Document Number: | P09000068796 |
| FEI/EIN Number | 27-0766618 |
| Address: | 766 N SUN DR., 1060, LAKE MARY, FL 32746 |
| Mail Address: | 315 W Blue Water Edge Dr, Eustis, FL 32736 |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912743659 | 2024-07-02 | 2024-07-02 | 315 W BLUE WATER EDGE DR, EUSTIS, FL, 327362255, US | 766 N SUN DR STE 1060, LAKE MARY, FL, 327462552, US | |||||||||||||||
|
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| Phone | +1 407-361-7565 |
| Phone | +1 407-322-5923 |
Authorized person
| Name | DR. CHESTER MILTENBERGER |
| Role | MEDICAL DIRECTOR |
| Phone | 3213035958 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| POLLEY, PATTY L | Agent | 315 W Blue Water Edge Dr, Eustis, FL 32736 |
| Name | Role | Address |
|---|---|---|
| POLLEY, PATTY L | President | 315 W Blue Water Edge Dr, Eustis, FL 32736 |
| Name | Role | Address |
|---|---|---|
| POLLEY, BRANDON | Vice President | 1086 Victoria Hills Dr. S, Deland, FL 32724 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-29 | 766 N SUN DR., 1060, LAKE MARY, FL 32746 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-29 | 766 N SUN DR., 1060, LAKE MARY, FL 32746 | No data |
| AMENDMENT | 2016-06-03 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-28 | 315 W Blue Water Edge Dr, Eustis, FL 32736 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-01-09 |
| Amendment | 2016-06-03 |
| ANNUAL REPORT | 2016-03-28 |
Date of last update: 24 Feb 2025
Sources: Florida Department of State
