| Entity Name: | JEC PHYSICIAN SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Nov 2009 (15 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 08 Jul 2021 (4 years ago) |
| Document Number: | L09000113702 |
| FEI/EIN Number | 27-1391917 |
| Address: | 5272 SUMMERLIN COMMONS WAY, SUITE 603, FT. MYERS, FL 33907 |
| Mail Address: | 5272 SUMMERLIN COMMONS WAY, SUITE 603, FT. MYERS, FL 33907 |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760911051 | 2017-06-08 | 2024-10-29 | 5272 SUMMERLIN COMMONS WAY STE 603, FORT MYERS, FL, 339072156, US | 5272 SUMMERLIN COMMONS WAY STE 603, FORT MYERS, FL, 339072156, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 239-444-8969 |
| Fax | 2394662035 |
Authorized person
| Name | MR. JULIO E CONRADO |
| Role | PRESIDENT |
| Phone | 2394448969 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME70286 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| License Number | ME70286 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 31742 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CONRADO, JULIO | Agent | 5272 SUMMERLIN COMMONS WAY, SUITE 603, FT. MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| CONRADO, JULIO | Managing Member | 5272 SUMMERLIN COMMONS WAY, SUITE 603 FT. MYERS, FL 33907 |
| Conrado, JENNY | Managing Member | 5272 SUMMERLIN COMMONS WAY, SUITE 603 FT. MYERS, FL 33907 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000063064 | COMPREHENSIVE SLEEP CARE OF SWFL | EXPIRED | 2017-06-07 | 2022-12-31 | No data | 14031 WEST HYDE PARK DR, #204, FORT MYERS, FL, 33912 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2021-07-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-07-08 | 5272 SUMMERLIN COMMONS WAY, SUITE 603, FT. MYERS, FL 33907 | No data |
| CHANGE OF MAILING ADDRESS | 2021-07-08 | 5272 SUMMERLIN COMMONS WAY, SUITE 603, FT. MYERS, FL 33907 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-07-08 | 5272 SUMMERLIN COMMONS WAY, SUITE 603, FT. MYERS, FL 33907 | No data |
| LC STMNT OF RA/RO CHG | 2017-09-01 | No data | No data |
| REINSTATEMENT | 2011-07-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-03 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-04-05 |
| LC Amendment | 2021-07-08 |
| ANNUAL REPORT | 2021-02-28 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-04-30 |
| CORLCRACHG | 2017-09-01 |
| ANNUAL REPORT | 2017-03-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5897447701 | 2020-05-01 | 0455 | PPP | 13670 METROPOLIS AVE STE 106, FORT MYERS, FL, 33912-4346 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 24 Feb 2025
Sources: Florida Department of State
