| Entity Name: | JILL M. ALLEN ARNP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 May 2010 (15 years ago) |
| Date of dissolution: | 21 Jun 2014 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 21 Jun 2014 (11 years ago) |
| Document Number: | L10000047148 |
| FEI/EIN Number | 272490507 |
| Address: | 351 Crossing Blvd, Orange Park, FL, 32703, US |
| Mail Address: | 351 Crossing Blvd, Orange Park, FL, 32703, US |
| ZIP code: | 32703 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588935712 | 2012-01-19 | 2012-11-18 | 3695 SCENIC HIGHWAY 98 UNIT 1004, DESTIN, FL, 325410700, US | 3695 SCENIC HIGHWAY 98 UNIT 1004, DESTIN, FL, 325410700, US | |||||||||||||||||||||||||||||||
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| Phone | +1 850-225-8811 |
| Fax | 8887950698 |
Authorized person
| Name | JILL M ALLEN |
| Role | OWNER |
| Phone | 8502258811 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| License Number | 1692262 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| License Number | 1692262 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI JILL M. ALLEN ARNP 1205877560 |
| Number | 1205877560 |
| Name | Role | Address |
|---|---|---|
| ALLEN JILL M | Agent | 351 Crossing Blvd, Orange Park, FL, 32703 |
| Name | Role | Address |
|---|---|---|
| ALLEN JILL | Managing Member | 351 Crossing Blvd, Orange Park, FL, 32703 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-06-21 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-21 | 351 Crossing Blvd, 118, Orange Park, FL 32703 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-21 | 351 Crossing Blvd, 118, Orange Park, FL 32703 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-21 | 351 Crossing Blvd, 118, Orange Park, FL 32703 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2014-06-21 |
| ANNUAL REPORT | 2013-04-21 |
| ANNUAL REPORT | 2012-04-26 |
| ANNUAL REPORT | 2011-04-29 |
| Florida Limited Liability | 2010-05-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
