| Entity Name: | AGELESS MEN'S HEALTH HOLDINGS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Active |
| Date Filed: | 27 Jun 2017 (8 years ago) |
| Document Number: | F17000002960 |
| FEI/EIN Number | 27-5505337 |
| Address: | 11112 San Jose Blvd., Suite 22, Jacksonville, FL 32223 |
| Mail Address: | 14358 N FRANK LLOYD WRIGHT, Suite 4, SCOTTSDALE, AZ 85260 |
| ZIP code: | 32223 |
| County: | Duval |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992440952 | 2022-05-03 | 2023-11-13 | 1240 MARBELLA PLAZA DR STE 102, TAMPA, FL, 336197906, US | 1240 MARBELLA PLAZA DR STE 102, TAMPA, FL, 336197906, US | |||||||||||||
|
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| Phone | +1 904-379-5052 |
Authorized person
| Name | TEAH MICHELLE SMITH |
| Role | CREDENTIALING MANAGER |
| Phone | 9012053999 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| NRAI SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| BLACKWOOD, JASON | President | 14358 N FRANK LLOYD WRIGHT, Suite 4 SCOTTSDALE, AZ 85260 |
| Name | Role | Address |
|---|---|---|
| MITIAS, HANNA M, MD | Vice President | 206 OXFORD RD, NEW ALBANY, MS 38652 |
| Name | Role | Address |
|---|---|---|
| BLACKWOOD, TAYLOR | Secretary | 14358 N FRANK LLOYD WRIGHT, Suite 4 SCOTTSDALE, AZ 85260 |
| Name | Role | Address |
|---|---|---|
| Kay, Susan | Chief Financial Officer | 14358 N Frank Lloyd Wright Blvd #4, Scottsdale, AZ 85260 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000102520 | AGELESS MEN'S HEALTH | ACTIVE | 2017-09-13 | 2027-12-31 | No data | 14350 N. FRANK LLOYD WRIGHT, SUITE 10, SCOTTSDALE, AZ, 85260 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-15 | 11112 San Jose Blvd., Suite 22, Jacksonville, FL 32223 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-22 | 11112 San Jose Blvd., Suite 22, Jacksonville, FL 32223 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-04-13 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-03-18 |
| ANNUAL REPORT | 2018-03-22 |
| Foreign Profit | 2017-06-27 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
