| Entity Name: | DR. R. JOHNSON, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jun 2011 (14 years ago) |
| Document Number: | L11000073558 |
| FEI/EIN Number | 383846706 |
| Address: | 2105 Park Ave., Orange Park, FL, 32073, US |
| Mail Address: | 2105 Park Ave., Orange Park, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336429448 | 2011-08-19 | 2011-08-19 | 7855 ARGYLE FOREST BLVD, SUITE 906, JACKSONVILLE, FL, 322445596, US | 7855 ARGYLE FOREST BLVD, SUITE 906, JACKSONVILLE, FL, 322445596, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-505-7861 |
| Fax | 9042916525 |
Authorized person
| Name | DR. ROBIN MICHELLE JOHNSON |
| Role | MANAGING MEMBER |
| Phone | 9045057861 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | PY7686 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PROVIDER NUMBER |
| Number | 1780856575 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHNSON ROBIN M | Agent | 9849 Crosshill Boulevard, Jacksonville, FL, 32222 |
| Name | Role | Address |
|---|---|---|
| Johnson Robin M | Managing Member | 9849 Crosshill Boulevard, Jacksonville, FL, 32222 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-03 | 9849 Crosshill Boulevard, 718, Jacksonville, FL 32222 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-01 | 2105 Park Ave., 23, Orange Park, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-01 | 2105 Park Ave., 23, Orange Park, FL 32073 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-01-08 | JOHNSON, ROBIN M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-02-23 |
| ANNUAL REPORT | 2015-03-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
