| Entity Name: | BAPTIST ENT SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Feb 2011 (14 years ago) |
| Document Number: | P11000016625 |
| FEI/EIN Number | 800690174 |
| Mail Address: | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207, US |
| Address: | 3563 PHILIPS HIGHWAY, Building A, SUITE 106, JACKSONVILLE, FL, 32207, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437658671 | 2018-02-02 | 2018-02-02 | PO BOX 41516, JACKSONVILLE, FL, 322031516, US | 11236 BAPTIST HEALTH DR STE 330, JACKSONVILLE, FL, 322182989, US | |||||||||||||||||||||
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| Phone | +1 904-202-5111 |
| Fax | 9043915836 |
| Phone | +1 904-202-5378 |
| Fax | 9043915498 |
Authorized person
| Name | CATHERINE GRAHAM |
| Role | VICE PRESIDENT |
| Phone | 9042022330 |
Taxonomy
| Taxonomy Code | 207Y00000X - Otolaryngology Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Agent | 841 PRUDENTIAL DR, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Graham Catherine | Director | 1660 Prudential Drive, Bldg. 2,, Jacksonville, FL, 32207 |
| Groover, MD Timothy | Director | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Graham Catherine | Vice President | 1660 Prudential Drive, Bldg. 2,, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Secretary | 841 PRUDENTIAL DRIVE, SUITE 1802, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Groover, MD Timothy | President | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Tickell Keith | Treasurer | 841 Prudential Drive, Suite 1602, Jacksonville, FL, 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-16 | 3563 PHILIPS HIGHWAY, Building A, SUITE 106, JACKSONVILLE, FL 32207 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-04-30 | Baity, G. Scott | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-27 | 841 PRUDENTIAL DR, SUITE 1802, JACKSONVILLE, FL 32207 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-22 |
| ANNUAL REPORT | 2024-04-09 |
| 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 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
