| Entity Name: | MEDIKON, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Feb 2012 (13 years ago) |
| Last Event: | LC DISSOCIATION MEM |
| Event Date Filed: | 21 Jun 2021 (4 years ago) |
| Document Number: | L12000027812 |
| FEI/EIN Number | 454645156 |
| Address: | 7077 NORMANDY BLVD, STE 5, JACKSONVILLE, FL, 32205, US |
| Mail Address: | 7077 NORMANDY BLVD, STE 5, JACKSONVILLE, FL, 32205, US |
| ZIP code: | 32205 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194078675 | 2012-10-20 | 2018-04-12 | 7077 NORMANDY BLVD, SUITE 5, JACKSONVILLE, FL, 322056279, US | 7077 NORMANDY BLVD, SUITE 5, JACKSONVILLE, FL, 322056279, US | |||||||||||||||||||||||||||||||
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| Phone | +1 904-900-7700 |
| Fax | 9045510794 |
Authorized person
| Name | NISHANT PATEL |
| Role | PHARMACY MANAGER |
| Phone | 9049007700 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26435 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008148500 |
| State | FL |
| Issuer | FLORIDA BOARD OF PHARMACY |
| Number | PH26435 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL NISHANT K | Agent | 7077 NORMANDY BLVD, JACKSONVILLE, FL, 32205 |
| Name | Role | Address |
|---|---|---|
| PATEL Nishant K | Managing Member | 7077 NORMANDY BLVD, JACKSONVILLE, FL, 32205 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000046088 | DUVAL PHARMACY 201 | ACTIVE | 2013-05-14 | 2028-12-31 | No data | 7077 NORMANDY BLVD STE 5, SUITE 5, JAVKSONVILLE, FL, 32205 |
| G12000058598 | DUVAL PHARMACY #201 | EXPIRED | 2012-06-13 | 2017-12-31 | No data | 2386 DUNN AVENUE, SUITE 117, JACKSONVILLE, FL, 32218 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC DISSOCIATION MEM | 2021-06-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-06-03 | PATEL, NISHANT K | No data |
| LC DISSOCIATION MEM | 2016-05-19 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-03-28 | 7077 NORMANDY BLVD, STE 5, JACKSONVILLE, FL 32205 | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-28 | 7077 NORMANDY BLVD, STE 5, JACKSONVILLE, FL 32205 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-07-25 | 7077 NORMANDY BLVD, STE 5, JACKSONVILLE, FL 32205 | No data |
| LC AMENDMENT | 2012-07-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-02-24 |
| ANNUAL REPORT | 2022-03-19 |
| CORLCDSMEM | 2021-06-21 |
| ANNUAL REPORT | 2021-02-28 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-01-31 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-01-12 |
| AMENDED ANNUAL REPORT | 2016-06-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
