| Entity Name: | DIAGNOSTIC CLINIC MEDICAL GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
DIAGNOSTIC CLINIC 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 24 Mar 1995 (30 years ago) |
| Last Event: | AMENDED AND RESTATEDARTICLES/NAME CHANGE |
| Event Date Filed: | 28 Dec 2012 (12 years ago) |
| Document Number: | P95000023879 |
| FEI/EIN Number |
593307922
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1301 2ND AVENUE SW, LARGO, FL, 33770, US |
| Mail Address: | 1301 2ND AVENUE SW, LARGO, FL, 33770, US |
| ZIP code: | 33770 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538833454 | 2021-08-04 | 2021-08-04 | 385 CYPRESS GARDENS BLVD, WINTER HAVEN, FL, 338804452, US | 385 CYPRESS GARDENS BLVD, WINTER HAVEN, FL, 338804452, US | |||||||||||||||||||||||||
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| Phone | +1 863-356-3754 |
| Fax | 8633565200 |
Authorized person
| Name | GINA MARIE PREBECK |
| Role | VP OF OPERATIONS |
| Phone | 7275599461 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | FLORIDA BLUE |
| Number | 00036 |
| State | FL |
| 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 |
| 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 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2016-11-02 | MACCARTHY, DEIRDRE | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-11-02 | 4800 DEERWOOD CAMPUS PARKWAY 100-7, JACKSONVILLE, FL 32246 | - |
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 2012-12-28 | DIAGNOSTIC CLINIC MEDICAL GROUP, INC. | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-02-12 | 1301 2ND AVENUE SW, LARGO, FL 33770 | - |
| CHANGE OF MAILING ADDRESS | 2010-02-12 | 1301 2ND AVENUE SW, LARGO, FL 33770 | - |
| AMENDMENT | 2000-02-25 | - | - |
| RESTATED ARTICLES | 1995-04-26 | - | - |
| 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 |
| 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 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
