| Entity Name: | MYRTLE RIDGE PRIMARY CARE P.A |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
MYRTLE RIDGE PRIMARY CARE P.A is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 19 Mar 2020 (5 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 07 Jul 2020 (5 years ago) |
| Document Number: | P20000024973 |
| FEI/EIN Number |
85-0505872
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1539 DALE MABRY HWY, SUIT #102, LUTZ, FL, AL, 33548, US |
| Mail Address: | 1539 DALE MABRY HWY, SUIT #102, LUTZ, FL, AL, 33548, US |
| ZIP code: | 33548 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700553633 | 2021-08-27 | 2024-05-06 | 1539 DALE MABRY HWY STE 102, LUTZ, FL, 335483008, US | 1539 DALE MABRY HWY STE 102, LUTZ, FL, 335483008, US | |||||||||||||||||||||||||
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| Phone | +1 813-909-7102 |
| Fax | 8139090199 |
Authorized person
| Name | YUDAISY MOGENA |
| Role | OFFICE MANAGER |
| Phone | 8139097102 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 111603900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TORRES PEREZ WILLIAM | President | 7403 MILESTONE DR, APOLLO BEACH, FL, 33572 |
| MOGENA YUDAISY | Authorized Member | 10618 DEERBERRY DR, LAND O LAKES, FL, 34638 |
| DORTA GEORGE M | Authorized Member | 10618 DEERBERRY DR, LAND O LAKES, FL, 34638 |
| MOGENA YUDAISY | Agent | 10618 DEERBERRY DR, LAND O LAKES, FL, 34638 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-03 | MOGENA, YUDAISY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-03 | 10618 DEERBERRY DR, LAND O LAKES, FL 34638 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-30 | 1539 DALE MABRY HWY, SUIT #102, LUTZ, FL, AL 33548 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | 1539 DALE MABRY HWY, SUIT #102, LUTZ, FL, AL 33548 | - |
| AMENDMENT | 2020-07-07 | - | - |
| NAME CHANGE AMENDMENT | 2020-05-04 | MYRTLE RIDGE PRIMARY CARE P.A | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| Amendment | 2020-07-07 |
| Name Change | 2020-05-04 |
| Domestic Profit | 2020-03-19 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
