| Entity Name: | PCA MEDICAL GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PCA MEDICAL GROUP, INC. 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: | 09 Apr 1993 (32 years ago) |
| Date of dissolution: | 27 Sep 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Sep 2016 (9 years ago) |
| Document Number: | P93000026827 |
| FEI/EIN Number |
593176364
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1715 N Westshore Blvd, Tampa, FL, 33607, US |
| Mail Address: | 1715 N Westshore Blvd, Tampa, FL, 33607, US |
| ZIP code: | 33607 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1144415837 | 2007-09-06 | 2016-03-14 | 1715 N WEST SHORE BLVD, SUITE 780, TAMPA, FL, 336073932, US | 34650 US 19 N, SUITE 104, PALM HARBOR, FL, 346842155, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-440-4402 |
| Fax | 8134404407 |
| Phone | +1 727-789-2922 |
| Fax | 7277874288 |
Authorized person
| Name | MR. C. ROSS BERRY |
| Role | PRESIDENT & CEO |
| Phone | 8134404402 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006386604 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386607 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386602 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386606 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386601 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386608 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386605 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006386603 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PCA MEDICAL GROUP INC 401 K PROFIT SHARING PLAN TRUST | 2015 | 593176364 | 2016-04-19 | PCA MEDICAL GROUP INC | 59 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2016-04-19 |
| Name of individual signing | C. ROSS BERRY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Berry C. Ross | President | 1715 N Westshore Blvd, Tampa, FL, 33607 |
| Edwards Jeffrey s | Chief Financial Officer | 1715 N Westshore Blvd, Tampa, FL, 33607 |
| Chandra Samarth | Secretary | 601 Lexington Ave, New York, NY, 10022 |
| Berry C. Ross | Agent | 1715 N Westshore Blvd, Tampa, FL, 33607 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000034400 | STARUS MEDICAL GROUP | EXPIRED | 2014-04-07 | 2019-12-31 | - | 1715 N. WESTSHORE BLVD., SUITE 780, TAMPA, FL, 33607 |
| G14000027507 | SYNGEIA MEDICAL GROUP | EXPIRED | 2014-03-18 | 2019-12-31 | - | 1715 N. WESTSHORE BLVD., SUITE 780, TAMPA, FL, 33607 |
| G13000048155 | PRIMARY CARE ASSOCIATES | EXPIRED | 2013-05-21 | 2018-12-31 | - | 3001 NORTH ROCKY POINT DRIVE EAST, SUITE 200, TAMPA, FL, 33607 |
| G12000079413 | PCA MEDICAL GROUP | EXPIRED | 2012-08-10 | 2017-12-31 | - | 3001 NORTH ROCKY POINT DRIVE, EAST, SUITE 200, TAMPA, FL, 33607 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-09-27 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-13 | 1715 N Westshore Blvd, Suite 780, Tampa, FL 33607 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-13 | 1715 N Westshore Blvd, Suite 780, Tampa, FL 33607 | - |
| CHANGE OF MAILING ADDRESS | 2015-03-13 | 1715 N Westshore Blvd, Suite 780, Tampa, FL 33607 | - |
| REGISTERED AGENT NAME CHANGED | 2015-03-13 | Berry, C. Ross | - |
| NAME CHANGE AMENDMENT | 2013-04-17 | PCA MEDICAL GROUP, INC. | - |
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 2012-03-08 | MEHUL K. PATEL, M.D., INC. | - |
| MERGER | 2001-12-31 | - | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 300000040213 |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2016-09-27 |
| ANNUAL REPORT | 2016-02-18 |
| ANNUAL REPORT | 2015-03-13 |
| ANNUAL REPORT | 2014-03-14 |
| ANNUAL REPORT | 2013-04-22 |
| Name Change | 2013-04-17 |
| Amended/Restated Article/NC | 2012-03-08 |
| ANNUAL REPORT | 2012-02-13 |
| ANNUAL REPORT | 2011-01-06 |
| ANNUAL REPORT | 2010-01-08 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
