| Entity Name: | PRIMARY CARE PHYSICIANS GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Nov 1995 (29 years ago) |
| Document Number: | P95000086989 |
| FEI/EIN Number | 650622370 |
| Address: | 4308 ALTON ROAD, SUITE 310, MIAMI BEACH, FL, 33140, US |
| Mail Address: | 4308 ALTON ROAD, SUITE 310, MIAMI BEACH, FL, 33140, US |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720424021 | 2013-05-14 | 2013-05-14 | 4308 ALTON RD, SUITE 860, MIAMI BEACH, FL, 331404556, US | 4308 ALTON RD, SUITE 860, MIAMI BEACH, FL, 331404556, US | |||||||||||||||||||||||||
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| Phone | +1 305-604-2888 |
| Fax | 3056042887 |
Authorized person
| Name | DR. GARY J MERLINO |
| Role | PRESIDENT |
| Phone | 3056042888 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| License Number | 9257323 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 262609800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MERLINO GARY IDr. | Agent | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| MERLINO GARY JDr. | President | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| MERLINO GARY JDr. | Treasurer | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| MERLINO GARY JDr. | Director | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| DEL VALLE ALEJANDRO Dr. | Director | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE ALEJANDRO Dr. | Vice President | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| DEL VALLE ALEJANDRO Dr. | Secretary | 4308 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-01 | 4308 ALTON ROAD, SUITE 310, MIAMI BEACH, FL 33140 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-01 | 4308 ALTON ROAD, SUITE 310, MIAMI BEACH, FL 33140 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-01 | 4308 ALTON ROAD, SUITE 310, MIAMI BEACH, FL 33140 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-25 | MERLINO, GARY I, Dr. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-27 |
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-01-30 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-03-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
