| Entity Name: | MONROSE CLINIC, ASSOCIATES FOR PSYCHOLOGICAL MEDICINE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MONROSE CLINIC, ASSOCIATES FOR PSYCHOLOGICAL MEDICINE, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 08 Apr 2008 (17 years ago) |
| Date of dissolution: | 24 Sep 2021 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (4 years ago) |
| Document Number: | L08000035794 |
| FEI/EIN Number |
593033202
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3169 Parador Way, JACKSONVILLE, FL, 32246, US |
| Mail Address: | 3169 Parador Way, JACKSONVILLE, FL, 32246, US |
| ZIP code: | 32246 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902076524 | 2008-03-11 | 2013-09-17 | 3627 UNIVERSITY BLVD S STE 615, JACKSONVILLE, FL, 322167401, US | 3627 UNIVERSITY BLVD SOUTH SUITE 615, JACKSONVILLE, FL, 322162721, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 904-725-6463 |
| Fax | 9047245006 |
Authorized person
| Name | DR. ATUL M SHAH |
| Role | PSYCHIATRISTS |
| Phone | 9047256463 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | ME0048902 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | TRICARE |
| Number | 081686072 |
| State | FL |
| Issuer | CHAMPUS |
| Number | 081686072 |
| State | FL |
| Issuer | AETNA |
| Number | 4115015 |
| State | FL |
| Issuer | BLUE CROSS |
| Number | 14203 |
| State | FL |
| Issuer | MAGELLAN |
| Number | 016627000 |
| State | FL |
| Issuer | WELLCARE |
| Number | 05770 |
| State | FL |
| Issuer | MEDICAID |
| Number | 043765400 |
| State | FL |
| Issuer | UNITED BEHAVIORAL HEALTH |
| Number | 05770 |
| State | FL |
| Issuer | FIRST HEALTH |
| Number | 081686072 |
| State | FL |
| Issuer | VALUE OPTIONS |
| Number | 088657 |
| State | FL |
| Issuer | GA. MEDICAID |
| Number | 256262286A |
| State | GA |
| Name | Role | Address |
|---|---|---|
| SHAH ATUL MMD | Managing Member | 3169 Parador Way, JACKSONVILLE, FL, 32246 |
| SHAH ATUL M | Agent | 3169 Parador Way, JACKSONVILLE, FL, 32246 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-09-26 | 3169 Parador Way, JACKSONVILLE, FL 32246 | - |
| CHANGE OF MAILING ADDRESS | 2019-09-26 | 3169 Parador Way, JACKSONVILLE, FL 32246 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-09-26 | 3169 Parador Way, JACKSONVILLE, FL 32246 | - |
| LC NAME CHANGE | 2010-08-02 | MONROSE CLINIC, ASSOCIATES FOR PSYCHOLOGICAL MEDICINE, PLLC | - |
| CONVERSION | 2008-04-08 | - | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS S10096. CONVERSION NUMBER 300000086583 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-01-31 |
| ANNUAL REPORT | 2019-09-26 |
| ANNUAL REPORT | 2018-04-19 |
| ANNUAL REPORT | 2017-02-22 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-05-01 |
| ANNUAL REPORT | 2014-04-14 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-04-11 |
| ANNUAL REPORT | 2011-03-23 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
