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BAPTIST UROLOGY, INC. - Florida Company Profile

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Company Details

Entity Name: BAPTIST UROLOGY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 17 Apr 2013 (12 years ago)
Document Number: P13000034970
FEI/EIN Number 46-2632312
Address: 3563 PHILIPS HWY, BUILDING A, SUITE 101, JACKSONVILLE, FL, 32207, US
Mail Address: 3563 PHILIPS HWY, BUILDING A, SUITE 101, JACKSONVILLE, FL, 32207, US
ZIP code: 32207
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Mayo Michael A President 841 Prudential Drive, Jacksonville, FL, 32207
Baity G. S Secretary 841 Prudential Drive, Jacksonville, FL, 32207
Groover, MD Timothy Director 841 Prudential Drive, Jacksonville, FL, 32207
GORAK EDWARD Vice President 841 Prudential Dr., Jacksonville, FL, 32207
TICKELL KEITH A Vice President 841 Prudential Dr., Jacksonville, FL, 32207
FINNEGAN T S Treasurer 841 Prudential Dr, Jacksonville, FL, 32207
Baity G. S Agent 841 PRUDENTIAL DR, SUITE 1802, JACKSONVILLE, FL, 32207

National Provider Identifier

NPI Number:
1689011710
Certification Date:
2025-06-11

Authorized Person:

Name:
MASHA DONALDSON
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
208800000X - Urology Physician
Is Primary:
Yes

Contacts:

Fax:
9043764075
Fax:
9043763271

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000041690 BAPTIST MEDICAL GROUP ACTIVE 2024-03-25 2029-12-31 - 3563 PHILIPS HIGHWAY, BLDG A, STE 101, JACKSONVILLE, FL, 32207

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2019-04-30 Baity, G. Scott -

Documents

Name Date
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
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-04-28
ANNUAL REPORT 2016-04-29
ANNUAL REPORT 2015-04-28

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Date of last update: 01 Aug 2025

Sources: Florida Department of State