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DEVOTED MEDICAL GROUP PROFESSIONAL CORPORATION - Florida Company Profile

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Company Details

Entity Name: DEVOTED MEDICAL GROUP PROFESSIONAL CORPORATION
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 03 Aug 2020 (5 years ago)
Document Number: P20000060357
FEI/EIN Number 85-2434574
Address: 221 CRESCENT STREET, SUITE 202, WALTHAM, MA, 02453, US
Mail Address: 221 CRESCENT STREET, SUITE 202, WALTHAM, MA, 02453, US
Place of Formation: FLORIDA

Links between entities

Type:
Headquarter of
Company Number:
1445945
State:
MISSISSIPPI
Type:
Headquarter of
Company Number:
1371371
State:
KENTUCKY
Type:
Headquarter of
Company Number:
20221976835
State:
COLORADO

Key Officers & Management

Name Role Address
- Agent -
Kocher Robert Chairman 221 CRESCENT STREET, WALTHAM, MA, 02453
JERNIGAN PAUL Secretary 221 CRESCENT STREET, WALTHAM, MA, 02453
Wagle Neil Chie 221 CRESCENT STREET, WALTHAM, MA, 02453
Yale W. Bradley Chief Financial Officer 221 CRESCENT STREET, WALTHAM, MA, 02453

National Provider Identifier

NPI Number:
1245838168
Certification Date:
2025-01-03

Authorized Person:

Name:
DR. NEIL WAGLE
Role:
CMO
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-04-27 2894 REMINGTON GREEN LANE, SUITE A, TALLAHASSEE, FL 32308 -
CHANGE OF PRINCIPAL ADDRESS 2022-04-23 221 CRESCENT STREET, SUITE 202, WALTHAM, MA 02453 -

Documents

Name Date
ANNUAL REPORT 2024-01-10
ANNUAL REPORT 2023-02-16
ANNUAL REPORT 2022-04-23
ANNUAL REPORT 2021-07-27
Domestic Profit 2020-08-03

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Date of last update: 02 Jul 2025

Sources: Florida Department of State