| Entity Name: | BAPTIST MD ANDERSON CANCER PHYSICIANS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Apr 2013 (12 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 08 Feb 2019 (6 years ago) |
| Document Number: | P13000033715 |
| FEI/EIN Number | 46-2620381 |
| Mail Address: | 841 Prudential Drive, Suite 1802, JACKSONVILLE, FL, 32207, US |
| Address: | 1301 PALM AVENUE, JACKSONVILLE, FL, 32207, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982472940 | 2023-12-19 | 2023-12-19 | PO BOX 746654, ATLANTA, GA, 303746654, US | 1301 PALM AVE STE 101, JACKSONVILLE, FL, 322078432, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-202-2092 |
| Fax | 9043937603 |
| Phone | +1 904-202-7300 |
| Fax | 9042027433 |
Authorized person
| Name | LEEANN MENGEL |
| Role | VICE PRESIDENT |
| Phone | 9042027300 |
Taxonomy
| Taxonomy Code | 207RH0000X - Hematology (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RH0003X - Hematology & Oncology Physician |
| Is Primary | No |
| Taxonomy Code | 207RX0202X - Medical Oncology Physician |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | No |
| Taxonomy Code | 2085R0001X - Radiation Oncology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Agent | 841 PRUDENTIAL DR, SUITE 1802, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Mayo Michael A | Director | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Zuino Matthew A | Director | 841 Prudential Dr, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Baity G. S | Secretary | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Mengel LeeAnn | Vice President | 1301 PALM AVENUE, JACKSONVILLE, FL, 32207 |
| Putnam, MD Bill | Vice President | 1235 San Marco Blvd., Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Tickell Keith | Treasurer | 841 Prudential Drive, Jacksonville, FL, 32207 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000041706 | BAPTIST MEDICAL GROUP | ACTIVE | 2024-03-25 | 2029-12-31 | No data | 1301 PALM AVENUE, JACKSONVILLE, FL, 32207 |
| G15000058472 | BAPTIST ONCOLOGY SPECIALISTS | EXPIRED | 2015-06-11 | 2020-12-31 | No data | 1235 SAN MARCO BOULEVARD, JACKSONVILLE, FL, 32207 |
| G15000050244 | BAPTIST MD ANDERSON CANCER PHYSICIANS | ACTIVE | 2015-05-21 | 2025-12-31 | No data | 1301 PALM AVENUE, JACKSONVILLE, FL, 32207 |
| G14000028324 | BAPTIST ONCOLOGY SERVICES | EXPIRED | 2014-03-20 | 2019-12-31 | No data | 3563 PHILIPS HIGHWAY, BUILDING A, SUITE 101, JACKSONVILLE, FL, 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-04-30 | Baity, G. Scott | No data |
| AMENDMENT AND NAME CHANGE | 2019-02-08 | BAPTIST MD ANDERSON CANCER PHYSICIANS, INC. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-08 | 1301 PALM AVENUE, JACKSONVILLE, FL 32207 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-28 | 1301 PALM AVENUE, JACKSONVILLE, FL 32207 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-22 |
| 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 |
| Amendment and Name Change | 2019-02-08 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
