| Entity Name: | DR. ROSANN W. FAULL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 07 Jul 2009 (16 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L09000065399 |
| FEI/EIN Number | 900510431 |
| Address: | 1729 Southcreek Drive, Jacksonville, FL, 32259, US |
| Mail Address: | 1729 Southcreek Drive, Jacksonville, FL, 32259, US |
| ZIP code: | 32259 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386974707 | 2010-01-07 | 2010-01-07 | 12276 SAN JOSE BLVD, SUITE 710, JACKSONVILLE, FL, 322238628, US | 12276 SAN JOSE BLVD, SUITE 710, JACKSONVILLE, FL, 322238628, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-262-5550 |
| Fax | 9046834592 |
Authorized person
| Name | ROSANN W FAULL |
| Role | AUDIOLOGIST/PRESIDENT |
| Phone | 9042625550 |
Taxonomy
| Taxonomy Code | 237600000X - Audiologist-Hearing Aid Fitter |
| License Number | AY 496 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUECROSS/BLUESHIELD |
| Number | J000A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FAULL ARTHUR | Agent | 1729 Southcreek Drive, Jacksonville, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| FAULL ROSANN W | Manager | 1729 Southcreek Drive, Jacksonville, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| FAULL ARTHUR V | Managing Member | 1729 Southcreek Drive, Jacksonville, FL, 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-08 | 1729 Southcreek Drive, Jacksonville, FL 32259 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-08 | 1729 Southcreek Drive, Jacksonville, FL 32259 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-08 | 1729 Southcreek Drive, Jacksonville, FL 32259 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-21 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-06-12 |
| ANNUAL REPORT | 2011-04-26 |
| ANNUAL REPORT | 2010-01-13 |
| Florida Limited Liability | 2009-07-07 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
