| Entity Name: | GAINESVILLE FAMILY PHYSICIANS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 24 Dec 1990 (34 years ago) |
| Document Number: | S22220 |
| FEI/EIN Number | 593042421 |
| Address: | 6900 NW 9TH BLVD, GAINESVILLE, FL, 32605 |
| Mail Address: | 6900 NW 9TH BLVD, SUITE B, GAINESVILLE, FL, 32605 |
| ZIP code: | 32605 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972601789 | 2006-09-20 | 2020-08-22 | 6900 NW 9TH BLVD, SUITE B, GAINESVILLE, FL, 326054201, US | 6900 NW 9TH BLVD, GAINESVILLE, FL, 326054201, US | |||||||||||||||||||||||||
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| Phone | +1 352-373-4359 |
| Fax | 3523736115 |
Authorized person
| Name | PATRICK R CARMICHAEL |
| Role | PRESIDENT |
| Phone | 3523734359 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME 30207 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF FLORIDA |
| Number | 21602 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMPSON DAVID A | Agent | 6900 NW 9TH BLVD, GAINESVILLE, FL, 32605 |
| Name | Role | Address |
|---|---|---|
| THOMPSON DAVID A | Director | 6900 NW 9 BLVD, GAINESVILLE, FL, 32605 |
| SHANNON KAREN W | Director | 6900 NW 9 BLVD, GAINESVILLE, FL, 32605 |
| BENCHIMOL GEORGE M | Director | 6900 NW 9 BLVD, GAINESVILLE, FL, 32605 |
| CARMICHAEL PATRICK R | Director | 6900 NW 9TH BLVD, GAINESVILLE, FL, 32605 |
| BRODSKY HAL M | Director | 6900 NW 9 BLVD, GAINESVILLE, FL, 32605 |
| Name | Role | Address |
|---|---|---|
| THOMPSON DAVID A | President | 6900 NW 9 BLVD, GAINESVILLE, FL, 32605 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2010-02-11 | No data | No data |
| AMENDMENT | 1998-04-23 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
