| Entity Name: | PATRICK J. OPACHICH, D.C.P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 27 Jul 1987 (38 years ago) |
| Document Number: | J84327 |
| FEI/EIN Number | 59-2828167 |
| Address: | 1610 BLANDING BLVD, JACKSONVILLE, FL 32210 |
| Mail Address: | 1610 BLANDING BLVD, JACKSONVILLE, FL 32210 |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699067041 | 2011-05-04 | 2021-02-18 | 1610 BLANDING BLVD, JACKSONVILLE, FL, 322101804, US | 1610 BLANDING BLVD, JACKSONVILLE, FL, 322101804, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 904-387-4151 |
| Fax | 9043898864 |
Authorized person
| Name | DR. PATRICK JOHNNY OPACHICH |
| Role | PRESIDENT |
| Phone | 9043874151 |
Taxonomy
| Taxonomy Code | 111NX0800X - Orthopedic Chiropractor |
| License Number | CH4041 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111NX0800X - Orthopedic Chiropractor |
| Is Primary | Yes |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381306100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OPACHICH, PATRICK J. | Agent | 1610 BLANDING BLVD, JACKSONVILLE, FL 32210 |
| Name | Role | Address |
|---|---|---|
| OPACHICH, PATRICK J | President | 1101 N. Cathy Tripp Ln, JACKSONVILLE, FL 32220 |
| Name | Role | Address |
|---|---|---|
| OPACHICH, PATRICK J | Secretary | 1101 N. Cathy Tripp Ln, JACKSONVILLE, FL 32220 |
| Name | Role | Address |
|---|---|---|
| OPACHICH, PATRICK J | Treasurer | 1101 N. Cathy Tripp Ln, JACKSONVILLE, FL 32220 |
| Name | Role | Address |
|---|---|---|
| OPACHICH, PATRICK J | Director | 1101 N. Cathy Tripp Ln, JACKSONVILLE, FL 32220 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000133126 | OPACHICH WELLNESS CENTER | ACTIVE | 2016-12-12 | 2026-12-31 | No data | 1610 BLANDING BLVD, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 1990-05-09 | 1610 BLANDING BLVD, JACKSONVILLE, FL 32210 | No data |
| CHANGE OF MAILING ADDRESS | 1990-05-09 | 1610 BLANDING BLVD, JACKSONVILLE, FL 32210 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1990-05-09 | 1610 BLANDING BLVD, JACKSONVILLE, FL 32210 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-12 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
