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DIAGNOSTIC CLINIC MEDICAL GROUP, INC. - Florida Company Profile

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Company Details

Entity Name: DIAGNOSTIC CLINIC MEDICAL GROUP, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 24 Mar 1995 (30 years ago)
Last Event: AMENDED AND RESTATEDARTICLES/NAME CHANGE
Event Date Filed: 28 Dec 2012 (13 years ago)
Document Number: P95000023879
FEI/EIN Number 593307922
Address: 1301 2ND AVENUE SW, LARGO, FL, 33770, US
Mail Address: 1301 2ND AVENUE SW, LARGO, FL, 33770, US
ZIP code: 33770
City: Largo
County: Pinellas
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Schrader Elana Dr. Chairman 4800 DEERWOOD CAMPUS PARKWAY DC 1-8, JACKSONVILLE, FL, 32246
Hall Allen Esq. Secretary 4800 DEERWOOD CAMPUS PARKWAY DC 1-7, JACKSONVILLE, FL, 32246
Trotter-Mitchell Shawn Director 4800 DEERWOOD CAMPUS PARKWAY DC 1-8, JACKSONVILLE, FL, 32246
WILLIAMS TRACY Dr. President 4800 DEERWOOD CAMPUS PARKWAY DC 1-9, JACKSONVILLE, FL, 32246
MACCARTHY DEIRDRE Agent 4800 DEERWOOD CAMPUS PARKWAY 100-7, JACKSONVILLE, FL, 32246

National Provider Identifier

NPI Number:
1538833454
Certification Date:
2021-08-04

Authorized Person:

Name:
GINA MARIE PREBECK
Role:
VP OF OPERATIONS
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8633565200

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000105249 GUIDEWELL PRIMARY CARE ACTIVE 2021-08-16 2026-12-31 - 4800 DEERWOOD CAMPUS PARKWAY, JACKSONVILLE, FL, 32246
G21000105248 GUIDEWELL PRIMARY CARE ACTIVE 2021-08-16 2026-12-31 - 385 CYPRESS GARDENS BLVD, WINTER HAVEN, FL, 33880

Events

Event Type Filed Date Value Description
CONVERSION 2025-05-23 - CONVERSION MEMBER. RESULTING CORPORATION WAS L25000231384. CONVERSION NUMBER 700000268687
REGISTERED AGENT ADDRESS CHANGED 2016-11-02 4800 DEERWOOD CAMPUS PARKWAY 100-7, JACKSONVILLE, FL 32246 -
REGISTERED AGENT NAME CHANGED 2016-11-02 MACCARTHY, DEIRDRE -
AMENDED AND RESTATEDARTICLES/NAME CHANGE 2012-12-28 DIAGNOSTIC CLINIC MEDICAL GROUP, INC. -
CHANGE OF MAILING ADDRESS 2010-02-12 1301 2ND AVENUE SW, LARGO, FL 33770 -
CHANGE OF PRINCIPAL ADDRESS 2010-02-12 1301 2ND AVENUE SW, LARGO, FL 33770 -
AMENDMENT 2000-02-25 - -
RESTATED ARTICLES 1995-04-26 - -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J03000067761 TERMINATED 02-15197SC HILLSBOROUGH COUNTY COURT 2003-01-14 2008-02-11 $5652.34 NANCY DOYLE, 9950 62ND TERRACE NORTH, #416, ST. PETERSBURG

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-04-06
ANNUAL REPORT 2022-04-05
AMENDED ANNUAL REPORT 2021-06-10
ANNUAL REPORT 2021-02-17
ANNUAL REPORT 2020-04-06
AMENDED ANNUAL REPORT 2019-08-20
ANNUAL REPORT 2019-02-13
ANNUAL REPORT 2018-04-13
ANNUAL REPORT 2017-03-23

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Date of last update: 03 Jul 2025

Sources: Florida Department of State