| Entity Name: | JAMIE R. SMOLEN, MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 10 Dec 2003 (21 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | L03000051588 |
| FEI/EIN Number | 200497019 |
| Address: | 3809 STATE ROAD 64 EAST, BRADENTON, FL, 34208 |
| Mail Address: | 3809 STATE ROAD 64 EAST, BRADENTON, FL, 34208 |
| ZIP code: | 34208 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447268131 | 2006-08-04 | 2023-03-07 | 3809 STATE ROAD 64 EAST, BRADENTON, FL, 34208, US | 3809 STATE ROAD 64 EAST, BRADENTON, FL, 34208, US | |||||||||||||||||||||||||||
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| Phone | +1 941-748-1848 |
Authorized person
| Name | DR. JAMIE ROBERT SMOLEN |
| Role | PRESIDENT |
| Phone | 9415188501 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | ME82196 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI # |
| Number | 1164470449 |
| Issuer | MEDICAL LICENSE |
| Number | ME82196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMOLEN JAMIE R | Agent | 3809 STATE ROAD 64 EAST, BRADENTON, FL, 34208 |
| Name | Role | Address |
|---|---|---|
| SMOLEN JAMIE R | Manager | 3809 STATE ROAD 64 EAST, BRADENTON, FL, 34208 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2008-06-29 | 3809 STATE ROAD 64 EAST, BRADENTON, FL 34208 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-14 | 3809 STATE ROAD 64 EAST, BRADENTON, FL 34208 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-01-14 | 3809 STATE ROAD 64 EAST, BRADENTON, FL 34208 | No data |
| REINSTATEMENT | 2005-03-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-01-27 |
| ANNUAL REPORT | 2011-03-10 |
| ANNUAL REPORT | 2010-01-27 |
| ANNUAL REPORT | 2009-04-06 |
| ANNUAL REPORT | 2008-06-29 |
| ANNUAL REPORT | 2007-01-14 |
| ANNUAL REPORT | 2006-04-27 |
| REINSTATEMENT | 2005-03-09 |
| Florida Limited Liabilites | 2003-12-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
