| Entity Name: | TRIDENT MEDICAL GROUP, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
TRIDENT MEDICAL GROUP, PA 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 29 Sep 2021 (4 years ago) |
| Date of dissolution: | 16 Feb 2024 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 16 Feb 2024 (a year ago) |
| Document Number: | P21000085122 |
| FEI/EIN Number |
87-2888744
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 382 NE 191ST STREET, MIAMI, FL, 33179, US |
| Mail Address: | 382 NE 191ST STREET, PMB 75481, MIAMI, FL, 33179-3899, US |
| ZIP code: | 33179 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295407922 | 2021-09-30 | 2022-11-14 | 1256 FOLSOM ST, SAN FRANCISCO, CA, 941033817, US | 382 NE 191ST ST, PMB 75481, MIAMI, FL, 331793899, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 310-626-0149 |
| Fax | 8558362741 |
| Phone | +1 855-770-7771 |
Authorized person
| Name | DEVION SMITH |
| Role | DIRECTOR, PAYER CONTRACTING |
| Phone | 4243268711 |
Taxonomy
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207XX0004X - Orthopaedic Foot and Ankle Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | No |
| Taxonomy Code | 213EP0504X - Public Medicine Podiatrist |
| Is Primary | Yes |
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| HENDERSON KIMBERLY MD | Chief Executive Officer | 333 SE 2ND ST, MIAMI, FL, 33131 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-02-16 | - | - |
| CHANGE OF MAILING ADDRESS | 2022-09-16 | 382 NE 191ST STREET, MIAMI, FL 33179 | - |
| AMENDMENT | 2022-04-13 | - | - |
| AMENDMENT | 2022-03-16 | - | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-02-16 |
| ANNUAL REPORT | 2023-09-15 |
| ANNUAL REPORT | 2022-09-16 |
| Amendment | 2022-04-13 |
| Amendment | 2022-03-16 |
| Domestic Profit | 2021-09-29 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
