| Entity Name: | BAPTIST PRIMARY CARE - INTERNAL MEDICAL GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Aug 2010 (14 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 15 Jun 2022 (3 years ago) |
| Document Number: | P10000065227 |
| FEI/EIN Number | 273236582 |
| Address: | 3563 PHILIPS HIGHWAY BUILDING A SUITE 101, JACKSONVILLE, FL, 32207 |
| Mail Address: | 841 PRUDENTIAL DRIVE SUITE 1802, JACKSONVILLE, FL, 32207 |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144508375 | 2011-07-21 | 2011-07-21 | 8614 BAYMEADOWS WAY, SUITE 100, JACKSONVILLE, FL, 322568234, US | 820 PRUDENTIAL DR, SUITE 314, JACKSONVILLE, FL, 322078210, US | |||||||||||||||
|
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| Phone | +1 904-396-0450 |
| Phone | +1 904-396-2223 |
Authorized person
| Name | EARL B MALLY |
| Role | SR. VICE PRESIDENT |
| Phone | 9043764275 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Agent | 841 PRUDENTIAL DRIVE SUITE 1802, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Zuino Matthew A | Director | 841 Prudential Drive, JACKSONVILLE, FL, 32207 |
| Donaldson Marsha | Director | 3563 Philips Highway, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Zuino Matthew A | President | 841 Prudential Drive, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Secretary | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Treasurer | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-06-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-04-30 | Baity, G. Scott | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12000861487 | TERMINATED | 1000000297916 | DUVAL | 2012-11-13 | 2022-11-28 | $ 331.89 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-25 |
| REINSTATEMENT | 2022-06-15 |
| 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 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-29 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
