| Entity Name: | SOUTHEASTERN HAND CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 01 Jul 1983 (42 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | G47546 |
| FEI/EIN Number | 59-2300119 |
| Address: | 1969 Beach Avenue, ATLANTIC BEACH, FL 32233 |
| Mail Address: | 1969 Beach Avenue, Atlantic Beach, FL 32233 |
| ZIP code: | 32233 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174615918 | 2006-09-29 | 2011-10-26 | 6100 KENNERLY RD, SUITE 202, JACKSONVILLE, FL, 322164368, US | 6100 KENNERLY RD, SUITE 202, JACKSONVILLE, FL, 322164368, US | |||||||||||||||||||||||||
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| Phone | +1 904-733-5550 |
| Fax | 9047335515 |
Authorized person
| Name | DR. JACK LEELAND GREIDER JR. |
| Role | PRESIDENT |
| Phone | 9047335550 |
Taxonomy
| Taxonomy Code | 207XS0106X - Orthopaedic Hand Surgery Physician |
| License Number | ME27693 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 37943300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GREIDER, JACK L. JR. | Agent | 1969 Beach Avenue, ATLANTIC BEACH, FL 32233 |
| Name | Role | Address |
|---|---|---|
| GREIDER, JACK L. | DR. | 1969 Beach Avenue, ATLANTIC BEACH, FL 32233 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000014234 | SOUTHEASTERN HAND AND THUMB CENTER | EXPIRED | 2012-02-09 | 2017-12-31 | No data | 6100 KENNERLY ROAD, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-08 | 1969 Beach Avenue, ATLANTIC BEACH, FL 32233 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-25 | 1969 Beach Avenue, ATLANTIC BEACH, FL 32233 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-25 | 1969 Beach Avenue, ATLANTIC BEACH, FL 32233 | No data |
| NAME CHANGE AMENDMENT | 1994-06-09 | SOUTHEASTERN HAND CENTER, P.A. | No data |
| NAME CHANGE AMENDMENT | 1985-07-24 | SOUTHEASTERN CENTER FOR HAND SURGERY AND REHABILITATION, P.A., JACK L. GREIDER, JR., M.D. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-04-08 |
| ANNUAL REPORT | 2014-03-25 |
| ANNUAL REPORT | 2013-03-18 |
| ANNUAL REPORT | 2012-02-23 |
| ANNUAL REPORT | 2011-02-09 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-03-26 |
| ANNUAL REPORT | 2008-04-15 |
| ANNUAL REPORT | 2007-04-19 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
