| Entity Name: | PARTNERS FAMILY MEDICINE PRACTICE AND ADDICTION RECOVERY CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Nov 2020 (4 years ago) |
| Document Number: | P20000088236 |
| FEI/EIN Number | 85-3596126 |
| Address: | 4453 US HIGHWAY 90, PACE, FL, 32571, US |
| Mail Address: | 4453 US HIGHWAY 90, PACE, FL, 32571, US |
| ZIP code: | 32571 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831791185 | 2020-11-11 | 2020-11-11 | 4453 HIGHWAY 90, PACE, FL, 325712066, US | 4453 HIGHWAY 90, PACE, FL, 325712066, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 850-905-0110 |
Authorized person
| Name | LAURA MAUPIN |
| Role | OWNER |
| Phone | 8509050110 |
Taxonomy
| Taxonomy Code | 207QA0401X - Addiction Medicine (Family Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SPORT JILL B | Agent | 5060 WOODBINE ROAD, PACE, FL, 32571 |
| Name | Role | Address |
|---|---|---|
| MAUPIN LAURA B | President | 5264 EMERALD DRIVE, PACE, FL, 32571 |
| Name | Role | Address |
|---|---|---|
| MAUPIN LAURA B | Secretary | 5264 EMERALD DRIVE, PACE, FL, 32571 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-02-05 |
| Domestic Profit | 2020-11-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
