| Entity Name: | SIGNATURE PHYSICIANS GROUP INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 22 Dec 2015 (9 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P15000101723 |
| FEI/EIN Number | 81-0974762 |
| Address: | 900 OSCEOLA DRIVE, Suite 200, WEST PALM BEACH, FL 33409 |
| Mail Address: | 900 OSCEOLA DRIVE, Suite 200, WEST PALM BEACH, FL 33409 |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841653805 | 2016-03-29 | 2016-03-29 | 900 OSCEOLA DR STE 200AB, WEST PALM BEACH, FL, 334095000, US | 900 OSCEOLA DR STE 200AB, WEST PALM BEACH, FL, 334095000, US | |||||||||||||||||||||||||
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| Phone | +1 561-500-7446 |
Authorized person
| Name | VERONICA HERNANDEZ |
| Role | OFFICE MANAGER |
| Phone | 9542033584 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| Is Primary | Yes |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 207QA0401X - Addiction Medicine (Family Medicine) Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MOBARAK, YUSEF KARIM | Agent | 780 Marina del ray, UNIT 5, WEST PALM BEACH, FL 33401 |
| Name | Role | Address |
|---|---|---|
| Mobarak, Yusef K | President | 900 OSCEOLA DRIVE, Suite 223 WEST PALM BEACH, FL 33409 |
| Name | Role | Address |
|---|---|---|
| Hernandez, Anselmo V | Chairman | 900 OSCEOLA DRIVE, Suite 223 WEST PALM BEACH, FL 33409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2017-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-09-27 | MOBARAK, YUSEF KARIM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-09-27 | 780 Marina del ray, UNIT 5, WEST PALM BEACH, FL 33401 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-09-09 | 900 OSCEOLA DRIVE, Suite 200, WEST PALM BEACH, FL 33409 | No data |
| AMENDMENT | 2016-09-09 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-09-09 | 900 OSCEOLA DRIVE, Suite 200, WEST PALM BEACH, FL 33409 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-12 |
| REINSTATEMENT | 2017-09-27 |
| Amendment | 2016-09-09 |
| ANNUAL REPORT | 2016-03-18 |
| Domestic Profit | 2015-12-22 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
