| Entity Name: | ROYAL PALM MEDICAL GROUP, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Oct 2009 (15 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 25 Jun 2013 (12 years ago) |
| Document Number: | P09000086067 |
| FEI/EIN Number | 271145281 |
| Address: | 2665 Cleveland AVE, FT. MYERS, FL, 33901, US |
| Mail Address: | 3660 CENTRAL AVE., STE 7, FT. MYERS, FL, 33901, US |
| ZIP code: | 33901 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487985610 | 2010-01-28 | 2021-02-10 | 2665 CLEVELAND AVE STE 102, FORT MYERS, FL, 339015884, US | 2665 CLEVELAND AVE STE 102, FORT MYERS, FL, 339015884, US | |||||||||||||||||||||||||||
|
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| Phone | +1 239-313-6300 |
| Fax | 2396895524 |
Authorized person
| Name | LAZARO GONZALEZ |
| Role | OWNER |
| Phone | 2393136300 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | MM24026 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GONZALEZ LAZARO A | Agent | 1012 SE 25TH LN, CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ LAZARO A | President | 1729 NW 17TH ST, CAPE CORAL, FL, 33993 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000145131 | ROYAL PALM CLINICAL RESEARCH | ACTIVE | 2023-11-30 | 2028-12-31 | No data | 2665 CLEVELAND AVE, STE 106, FORT MYERS, FL, 33901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-09-03 | 2665 Cleveland AVE, Ste 102, FT. MYERS, FL 33901 | No data |
| AMENDMENT | 2013-06-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-06-25 | 2665 Cleveland AVE, Ste 102, FT. MYERS, FL 33901 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-03-15 |
| ANNUAL REPORT | 2021-02-28 |
| ANNUAL REPORT | 2020-03-06 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-03-29 |
| ANNUAL REPORT | 2016-03-13 |
| ANNUAL REPORT | 2015-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
