| Entity Name: | NFAM PHYSICIAN GROUP INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Nov 2014 (10 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 20 Dec 2016 (8 years ago) |
| Document Number: | P14000095275 |
| FEI/EIN Number | 47-2373604 |
| Address: | 642 S Military Trl, Deerfield Beach, FL, 33442, US |
| Mail Address: | 642 S Military Trl, Deerfield Beach, FL, 33442, US |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992102891 | 2014-11-21 | 2014-11-21 | 1100 PARK CENTRAL BLVD S STE 3400, POMPANO BEACH, FL, 330642265, US | 1900 CORPORATE SQUARE BLVD, JACKSONVILLE, FL, 322161941, US | |||||||||||||||
|
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| Phone | +1 954-691-0830 |
| Fax | 9546910834 |
Authorized person
| Name | MISS DONNA CAMPBELL |
| Role | DIRECTOR OF BILLLING AND COLLECTION |
| Phone | 9546910856 |
Taxonomy
| Taxonomy Code | 207RA0401X - Addiction Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Johnson Phillip C | Agent | 1200 S PINE ISLAND RD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Kircher III Robert E | Chairman | 642 S Military Trl, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Stevens Jamie | Chief Executive Officer | 642 S Military Trl, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Leong Franklin | Auth | 642 S Military TRL, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Johnson Phillip C | Chief Financial Officer | 642 S Military TRL, Deerfield Beach, FL, 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-03-13 | Johnson, Phillip Clay | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-20 | 642 S Military Trl, Deerfield Beach, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-20 | 642 S Military Trl, Deerfield Beach, FL 33442 | No data |
| AMENDMENT | 2016-12-20 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-12-20 | 1200 S PINE ISLAND RD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-03-09 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-01-31 |
| ANNUAL REPORT | 2017-03-21 |
| Amendment | 2016-12-20 |
| ANNUAL REPORT | 2016-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
