| Entity Name: | BLOCK, NATION, CHASE, & SMOLEN FAMILY MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 May 1997 (28 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 31 Mar 2010 (15 years ago) |
| Document Number: | P97000047391 |
| FEI/EIN Number | 59-3451416 |
| Address: | 2441 W. STATE RD 426, 2011, OVIEDO, FL 32765 |
| Mail Address: | 2441 W. STATE RD 426, 2011, OVIEDO, FL 32765 |
| ZIP code: | 32765 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679671200 | 2006-09-20 | 2013-01-28 | 2441 WEST STATE ROAD 426, SUITE 2011, OVIEDO, FL, 327654515, US | 2441 WEST STATE ROAD 426, SUITE 2011, OVIEDO, FL, 327654515, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-678-6888 |
| Fax | 4076780252 |
Authorized person
| Name | BRADLEY M BLOCK |
| Role | OWNER |
| Phone | 4076786888 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME0061495 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | OS0007059 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME0074034 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME90314 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Weatherford, William P | Agent | 3203 Lawton Road, Suite 100, Orlando, FL 32803 |
| Name | Role | Address |
|---|---|---|
| BLOCK, BRADLEY | Director | 2441 W. STATE ROAD 426, STE 2011, OVIEDO, FL 32765 |
| NATION, AMY J | Director | 2441 W. STATE ROAD 426, STE 2011, OVIEDO, FL 32765 |
| CRAIG, CHASE P | Director | 2441 W. STATE ROAD 426, STE 2011, OVIEDO, FL 32765 |
| SMOLEN, SUSAN G | Director | 2441 W. STATEROAD 426, STE 2011, OVIEDO, FL 32765 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000032540 | BLOCK & NATION, P.A. | EXPIRED | 2010-04-12 | 2015-12-31 | No data | 2441 W. STATE ROAD 426, STE 2011, OVIEDO, FL, 32765 |
| G10000032541 | BNCSFM | EXPIRED | 2010-04-12 | 2015-12-31 | No data | 2441 W. STATE ROAD 426, STE 2011, OVIEDO, FL, 32765 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-03 | 3203 Lawton Road, Suite 100, Orlando, FL 32803 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-09 | Weatherford, William P | No data |
| AMENDMENT AND NAME CHANGE | 2010-03-31 | BLOCK, NATION, CHASE, & SMOLEN FAMILY MEDICINE, INC. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-03-19 | 2441 W. STATE RD 426, 2011, OVIEDO, FL 32765 | No data |
| CHANGE OF MAILING ADDRESS | 2008-03-19 | 2441 W. STATE RD 426, 2011, OVIEDO, FL 32765 | No data |
| CANCEL ADM DISS/REV | 2006-11-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| CANCEL ADM DISS/REV | 2005-05-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-02-04 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-01-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
