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HOSPITALIST GROUP OF NORTHWEST FLORIDA, INC. - Florida Company Profile

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Company Details

Entity Name: HOSPITALIST GROUP OF NORTHWEST FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 12 Apr 2021 (4 years ago)
Document Number: P21000032516
FEI/EIN Number 86-3247242
Address: 4000 Highway 90, Pace, FL, 32571, US
Mail Address: 4000 Highway 90, Pace, FL, 32571, US
ZIP code: 32571
City: Milton
County: Santa Rosa
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
SAMII STEVEN SM.D. Director 31 E. GALVEZ COURT, PENSACOLA BEACH, FL, 32561
BAUTISTA ROMAN SD.O. Director 3978 GORDON WELLS DRIVE, MILTON, FL, 32583
BAUTISTA ROMAN SD.O. Agent 4000 Highway 90, Pace, FL, 32571

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
EVIE DUCKWORTH
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business
User ID:
P3165967
Trade Name:
HOSPITALIST GROUP OF NORTHWEST FLORIDA INC

Unique Entity ID

Unique Entity ID:
PCYNT8HPTCJ9
CAGE Code:
9PFQ2
UEI Expiration Date:
2026-05-19

Business Information

Doing Business As:
HOSPITALIST GROUP OF NORTHWEST FLORIDA INC
Activation Date:
2025-05-21
Initial Registration Date:
2023-07-27

Commercial and government entity program

CAGE number:
9PFQ2
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-05-21
CAGE Expiration:
2030-05-21
SAM Expiration:
2026-05-19

Contact Information

POC:
EVIE DUCKWORTH

National Provider Identifier

NPI Number:
1386385045
Certification Date:
2025-05-05

Authorized Person:

Name:
ROMAN BAUTISTA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208M00000X - Hospitalist Physician
Is Primary:
Yes

Contacts:

Fax:
8504749060

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-04-29 4000 Highway 90, Suite I, Pace, FL 32571 -
CHANGE OF MAILING ADDRESS 2022-04-29 4000 Highway 90, Suite I, Pace, FL 32571 -
REGISTERED AGENT ADDRESS CHANGED 2022-04-29 4000 Highway 90, Suite I, Pace, FL 32571 -

Documents

Name Date
ANNUAL REPORT 2024-05-01
ANNUAL REPORT 2023-04-30
ANNUAL REPORT 2022-04-29
Domestic Profit 2021-04-12

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Date of last update: 02 Aug 2025

Sources: Florida Department of State