| Entity Name: | HERMAN M. DUPERAULT, JR., O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Apr 1989 (36 years ago) |
| Date of dissolution: | 11 Mar 2014 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 11 Mar 2014 (11 years ago) |
| Document Number: | K78086 |
| FEI/EIN Number | 59-2938763 |
| Address: | % DR. HERMAN M. DUPERAULT, JR., 326 BROAD STREET, JACKSONVILLE, FL 32202 |
| Mail Address: | % DR. HERMAN M. DUPERAULT, JR., 3078 MERRILL BOULEVARD, JACKSONVILLE BEACH, FL 32250 |
| ZIP code: | 32202 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710900824 | 2006-07-26 | 2008-06-20 | 3078 MERRILL BLVD, JACKSONVILLE BEACH, FL, 322508163, US | 447 ATLANTIC BLVD, SUITE 1, ATLANTIC BEACH, FL, 322334004, US | |||||||||||||||||||||||||||||
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| Phone | +1 904-246-0404 |
| Fax | 9042460404 |
| Phone | +1 904-246-4372 |
| Fax | 9042466115 |
Authorized person
| Name | DR. HERMAN M DUPERAULT JR. |
| Role | PRESIDENT |
| Phone | 9042460404 |
Taxonomy
| Taxonomy Code | 305S00000X - Point of Service |
| License Number | OPC 672 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 084332600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DUPERAULT, HERMAN M., JR. | Agent | 3078 MERRILL BOULEVARD, JACKSONVILLE BEACH, FL 32250 |
| Name | Role | Address |
|---|---|---|
| DUPERAULT JR., HERMAN M. | Chairman | 3078 MERRILL BOULEVARD, JACKSONVILLE BCH., FL 32250 |
| Name | Role | Address |
|---|---|---|
| DUPERAULT JR., HERMAN M. | President | 3078 MERRILL BOULEVARD, JACKSONVILLE BCH., FL 32250 |
| Name | Role | Address |
|---|---|---|
| DUPERAULT JR., HERMAN M. | Treasurer | 3078 MERRILL BOULEVARD, JACKSONVILLE BCH., FL 32250 |
| Name | Role | Address |
|---|---|---|
| DUPERAULT JR., HERMAN M. | Vice President | 3078 MERRILL BOULEVARD, JACKSONVILLE BCH., FL 32250 |
| Name | Role | Address |
|---|---|---|
| DUPERAULT JR., HERMAN M. | Secretary | 3078 MERRILL BOULEVARD, JACKSONVILLE BCH., FL 32250 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-03-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-22 | % DR. HERMAN M. DUPERAULT, JR., 326 BROAD STREET, JACKSONVILLE, FL 32202 | No data |
| CHANGE OF MAILING ADDRESS | 2006-04-12 | % DR. HERMAN M. DUPERAULT, JR., 326 BROAD STREET, JACKSONVILLE, FL 32202 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-17 | 3078 MERRILL BOULEVARD, JACKSONVILLE BEACH, FL 32250 | No data |
| REINSTATEMENT | 2002-12-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2002-10-04 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2014-03-11 |
| ANNUAL REPORT | 2013-04-14 |
| ANNUAL REPORT | 2012-04-22 |
| ANNUAL REPORT | 2011-04-22 |
| ANNUAL REPORT | 2010-04-26 |
| ANNUAL REPORT | 2009-03-25 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-11 |
| ANNUAL REPORT | 2006-04-12 |
| ANNUAL REPORT | 2005-04-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
