{"entity":{"id":11235679,"state":"FL","state_id":"G57885","entity_name":"PHYSICIAN PROVIDER GROUP, INC.","entity_type":"DOMP","entity_type_normalized":"domestic_profit","status":"I","filing_date":"1983-09-01","filing_year":1983,"business_age_years":43,"principal_address1":"100 N.W. 70TH AVE.","principal_address2":"8200 W. SUNRISE BLVD, BLDG C","principal_city":"PLANTATION","principal_state":"FL","principal_zip":"33317","principal_country":"","mail_address1":"100 N.W. 70TH AVE.","mail_address2":"8200 W. SUNRISE BLVD, BLDG C","mail_city":"PLANTATION","mail_state":"FL","mail_zip":"33317","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"592322240","jurisdiction":null,"county":null,"last_transaction_date":"09281988","report_year_1":"1988","report_date_1":"06131988","report_year_2":"1988","report_date_2":"06131988","report_year_3":"1987","report_date_3":"03241987","agent_name":"Jere D., Creed MD","agent_type":"C","agent_address":"100 N.W. 70TH AVE.","agent_city":"PLANTATION","agent_state":"FL","agent_zip":"33317","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata5.txt","fetched_at":"2026-05-09 13:02:06","updated_at":"2026-05-09 13:02:06","last_accessed":null,"status_reason":null,"agent_name_raw":"CREED, JERE D., M.D."},"officers":[{"name":"Jere D., Creed MD","first_name":"Jere","last_name":"Creed","title":"Director, Vice President","title_roles":["Director","Vice President"],"title_code":"dv","is_registered_agent":true,"address":"100 N.W. 70TH AVE.","city":"PLANTATION","state":"FL","zip":"","name_raw":"CREED, JERE D., M.D."},{"name":"William A.,M.D. Davison","first_name":"William","last_name":"Davison","title":"Director, Vice President, Secretary","title_roles":["Director","Vice President","Secretary"],"title_code":"dvs","is_registered_agent":false,"address":"100 N.W. 70TH AVE.","city":"PLANTATION","state":"FL","zip":"","name_raw":"DAVISON, WILLIAM A.,M.D."},{"name":"Clifford, Findeiss MD","first_name":"Clifford,","last_name":"Findeiss","title":"Director, President","title_roles":["Director","President"],"title_code":"dp","is_registered_agent":false,"address":"100 N.W. 70TH AVE.","city":"PLANTATION","state":"FL","zip":"","name_raw":"FINDEISS, CLIFFORD, M.D."},{"name":"Daniel E., Lucas MD","first_name":"Daniel","last_name":"Lucas","title":"Director, Vice President","title_roles":["Director","Vice President"],"title_code":"dv","is_registered_agent":false,"address":"100 N.W. 70TH AVE.","city":"PLANTATION","state":"FL","zip":"","name_raw":"LUCAS, DANIEL E., M.D."},{"name":"Neil J. Principe MD","first_name":"Neil","last_name":"Principe","title":"Director, Vice President","title_roles":["Director","Vice President"],"title_code":"dv","is_registered_agent":false,"address":"100 N.W. 70TH AVE.","city":"PLANTATION","state":"FL","zip":"","name_raw":"PRINCIPE, NEIL J. M.D."},{"name":"Victor J. Weinstein MD","first_name":"Victor","last_name":"Weinstein","title":"Director, Vice President, Treasurer","title_roles":["Director","Vice President","Treasurer"],"title_code":"dvt","is_registered_agent":false,"address":"100 N.W. 70TH AVE.","city":"PLANTATION","state":"FL","zip":"","name_raw":"WEINSTEIN, VICTOR J. M.D"}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/G57885"}