| Entity Name: | EMERGENCY MEDICAL SPECIALISTS OF JACKSONVILLE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Jul 2014 (11 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 09 Jul 2014 (11 years ago) |
| Document Number: | L14000111368 |
| FEI/EIN Number | 59-1926199 |
| Address: | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204, US |
| Mail Address: | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204, US |
| ZIP code: | 32204 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538834866 | 2021-08-10 | 2021-08-10 | PO BOX 863026, ORLANDO, FL, 328863026, US | 1670 ST VINCENTS WAY, MIDDLEBURG, FL, 320688447, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 904-308-7300 |
Authorized person
| Name | ANDREW S. VIHLEN |
| Role | PRESIDENT |
| Phone | 9043087300 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EMSJ RETIREMENT PLAN | 2023 | 591926199 | 2024-03-29 | EMERGENCY MEDICAL SPECIALISTS OF JACKSONVILLE, PLLC | 71 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-03-29 |
| Name of individual signing | ANDREW VIHLEN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9043088435 |
| Plan sponsor’s address | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 322044748 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-13 |
| Name of individual signing | ANDREW VIHLEN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9043088435 |
| Plan sponsor’s address | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 322044748 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-04 |
| Name of individual signing | ANDREW VIHLEN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9043088435 |
| Plan sponsor’s address | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 322044748 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9043088435 |
| Plan sponsor’s address | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 322044748 |
| Name | Role | Address |
|---|---|---|
| VIHLEN ANDREW | Agent | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Name | Role | Address |
|---|---|---|
| VIHLEN ANDREW | President | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-03-11 | VIHLEN, ANDREW | No data |
| CONVERSION | 2014-07-09 | No data | GEN-COR CONVERSION RESULT. THE CONVERTING ENTITY WAS GP1400000929 ORIGINALLY FILED ON 07/08/2014. CONVERSION NUMBER 900000142189 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-03-22 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
