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  5. JACKSONVILLE HOSPITALISTS, P.A.

JACKSONVILLE HOSPITALISTS, P.A.

Company Details

Entity Name: JACKSONVILLE HOSPITALISTS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 15 Feb 1999 (26 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 15 Oct 2020 (4 years ago)
Document Number: P99000015332
FEI/EIN Number 593577370
Address: JACKSONVILLE HOSPITALISTS, P.A., 8613 Old Kings Road South, JACKSONVILLE, FL, 32217, US
Mail Address: JACKSONVILLE HOSPITALISTS, P.A., 8613 Old Kings Road South, JACKSONVILLE, FL, 32217, US
ZIP code: 32217
County: Duval
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2022 593577370 2023-09-28 JACKSONVILLE HOSPITALISTS, P.A. 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2023-09-28
Name of individual signing ANDREW ESCAMILLA
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2021 593577370 2022-09-20 JACKSONVILLE HOSPITALISTS, P.A. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing ANDREW ESCAMILLA
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2020 593577370 2022-09-20 JACKSONVILLE HOSPITALISTS, P.A. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing ANDREW ESCAMILLA
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2020 593577370 2021-10-11 JACKSONVILLE HOSPITALISTS, P.A. 33
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing ANDREW ESCAMILLA
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2019 593577370 2022-09-20 JACKSONVILLE HOSPITALISTS, P.A. 45
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing ANDREW ESCAMILLA
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2019 593577370 2020-10-15 JACKSONVILLE HOSPITALISTS, P.A. 36
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing INDIA L. MURDAUGH
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2018 593577370 2020-10-15 JACKSONVILLE HOSPITALISTS, P.A. 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing INDIA L. MURDAUGH
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2018 593577370 2019-10-14 JACKSONVILLE HOSPITALISTS, P.A. 29
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8733 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing INDIA L. MURDAUGH
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2017 593577370 2018-04-13 JACKSONVILLE HOSPITALISTS, P.A. 49
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2018-04-13
Name of individual signing TRISHA BOWLES
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE HOSPITALISTS, P.A. 401(K) PROFIT SHARING PLAN 2016 593577370 2017-10-13 JACKSONVILLE HOSPITALISTS, P.A. 45
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9044933390
Plan sponsor’s address 8773 PERIMETER PARK COURT, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing TRISHA BOWLES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CRISMOND KEVIN D Agent JACKSONVILLE HOSPITALISTS, P.A., JACKSONVILLE, FL, 32217

President

Name Role Address
BLATT MARC B President JACKSONVILLE HOSPITALISTS, P.A., JACKSONVILLE, FL, 32217
CRISMOND KEVIN D President JACKSONVILLE HOSPITALISTS, P.A., JACKSONVILLE, FL, 32217

Vice President

Name Role Address
CRISMOND KEVIN D Vice President JACKSONVILLE HOSPITALISTS, P.A., JACKSONVILLE, FL, 32217

Chief Executive Officer

Name Role Address
Escamilla Andrew G Chief Executive Officer JACKSONVILLE HOSPITALISTS, P.A., JACKSONVILLE, FL, 32217

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000030816 MEMORIAL HOSPITALISTS EXPIRED 2013-03-29 2018-12-31 No data 13500 SUTTON PARK DRIVE, S., SUITE 403, JACKSONVILLE, FL, 32224
G13000012131 ORANGE PARK HOSPITALISTS EXPIRED 2013-02-04 2018-12-31 No data 13500 SUTTON PARK DRIVE, S., SUITE 601, JACKSONVILLE, FL, 32204
G11000068050 CISCA PULMONARY AND CRITICAL CARE EXPIRED 2011-07-07 2016-12-31 No data 13500 SUTTON PARK DRIVE, SOUTH, SUITE 601, JACKSONVILLE, FL, 32224

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-03-01 JACKSONVILLE HOSPITALISTS, P.A., 8613 Old Kings Road South, 602, JACKSONVILLE, FL 32217 No data
CHANGE OF MAILING ADDRESS 2023-03-01 JACKSONVILLE HOSPITALISTS, P.A., 8613 Old Kings Road South, 602, JACKSONVILLE, FL 32217 No data
REGISTERED AGENT ADDRESS CHANGED 2023-03-01 JACKSONVILLE HOSPITALISTS, P.A., 8613 Old Kings Road South, 602, JACKSONVILLE, FL 32217 No data
REINSTATEMENT 2020-10-15 No data No data
REGISTERED AGENT NAME CHANGED 2020-10-15 CRISMOND, KEVIN D.O. No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data

Documents

Name Date
ANNUAL REPORT 2024-03-02
ANNUAL REPORT 2023-03-01
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-08-16
REINSTATEMENT 2020-10-15
ANNUAL REPORT 2019-03-11
ANNUAL REPORT 2018-04-23
ANNUAL REPORT 2017-01-12
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-01-12

Related by officers

BLATT MARC B

MARK REAL ESTATE HOLDINGS, LLC JACKSONVILLE MANAGEMENT & STAFFING, INC.

CRISMOND KEVIN D

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Escamilla Andrew G

COMPLETE PRACTICE MANAGEMENT SOLUTIONS LLC MEDICAL FACILITY PARTNERS LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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