| Entity Name: | ST. JUDE MEDICAL & AESTHETIC CARE CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Oct 2010 (14 years ago) |
| Document Number: | L10000105351 |
| FEI/EIN Number | 273642852 |
| Address: | 1039 E Brandon Blvd, BRANDON, FL, 33511, US |
| Mail Address: | 13317 Fawn Lily Dr, Riverview, FL, 33579, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518260090 | 2010-12-06 | 2013-10-08 | 4810 PORTOBELLO CIR, VALRICO, FL, 33596, US | 131 N MOON AVE, SUITES 3 & 4, BRANDON, FL, 335104418, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-315-9898 |
| Fax | 8134385967 |
Authorized person
| Name | DR. GODWIN STANLEY OKOYE |
| Role | MEDICAL DIRECTOR |
| Phone | 8133306613 |
Taxonomy
| Taxonomy Code | 132700000X - Dietary Manager |
| Is Primary | No |
| Taxonomy Code | 146D00000X - Personal Emergency Response Attendant |
| License Number | ME107980 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207QA0401X - Addiction Medicine (Family Medicine) Physician |
| License Number | ME107980 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME107980 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 2083P0901X - Public Health & General Preventive Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME107980 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208U00000X - Clinical Pharmacology Physician |
| License Number | ME107980 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| OKOYE GODWIN SMD, PHD | Agent | 1039 E Brandon Blvd, BRANDON, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| OKOYE GODWIN SMD, PHD | Manager | 1039 E Brandon Blvd, Brandon, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| Okoye Chioma M | Auth | 1039 E Brandon Blvd, BRANDON, FL, 33511 |
| Okoye Ifeoma F | Auth | 1039 E Brandon Blvd, BRANDON, FL, 33511 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000056725 | ST. JUDE MEDICAL CENTER & AESTHETIC CARE | ACTIVE | 2018-05-08 | 2028-12-31 | No data | 13317 FAWN LILY DR, RIVERVIEW, FL, 33579 |
| G16000021554 | ST. JUDE MEDICAL CENTER & AESTHETIC CARE | EXPIRED | 2016-02-29 | 2021-12-31 | No data | 4810 PORTOBELLO CIR, VALRICO, FL, 33596 |
| G11000106320 | BIOGEVITY | EXPIRED | 2011-10-31 | 2016-12-31 | No data | 131 N. MOON AVE, SUITES 3 & 4, BRANDON, FL, 33510 |
| G10000114756 | ST. JUDE EYE CLINIC & SKIN CARE | EXPIRED | 2010-12-15 | 2015-12-31 | No data | 4810 PORTOBELLO CIR, VALRICO, FL, 33596 |
| G10000093772 | ST. JUDE MEDICAL CENTER & AESTHETIC CARE | EXPIRED | 2010-10-13 | 2015-12-31 | No data | 4810 PORTOBELLO CIR, VALRICO, FL, 33596 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-01 | 1039 E Brandon Blvd, #1039 & #1041, BRANDON, FL 33511 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-01 | 1039 E Brandon Blvd, #1039 & #1041, BRANDON, FL 33511 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-05-08 | OKOYE, GODWIN STANLEY, MD, PHD | No data |
| CHANGE OF MAILING ADDRESS | 2016-05-01 | 1039 E Brandon Blvd, #1039 & #1041, BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-05-03 |
| ANNUAL REPORT | 2018-05-08 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-05-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
