| Entity Name: | JONG YUN PARK, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Oct 2014 (10 years ago) |
| Document Number: | L14000166249 |
| FEI/EIN Number | 47-2177211 |
| Address: | 11806 ATLANTIC BLVD, JACKSONVILLE, FL, 32225, US |
| Mail Address: | 130 CORRIDOR RD, PO BOX 634, Ponte Vedra BEACH, FL, 32004, US |
| ZIP code: | 32225 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043615107 | 2014-10-30 | 2014-10-30 | 11806 ATLANTIC BLVD, JACKSONVILLE, FL, 322252918, US | 11806 ATLANTIC BLVD, JACKSONVILLE, FL, 322252918, US | |||||||||||||||||||
|
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| Phone | +1 315-454-6000 |
| Fax | 3154384483 |
Authorized person
| Name | MIKA WEISS |
| Role | PROVIDER RELATIONS |
| Phone | 3154546000 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN20765 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PARK JONG YUN | Agent | 11806 ATLANTIC BLVD, JACKSONVILLE, FL, 32225 |
| Name | Role | Address |
|---|---|---|
| PARK JONG YUN | Authorized Member | 11806 ATLANTIC BLVD, JACKSONVILLE, FL, 32225 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-07-26 | 11806 ATLANTIC BLVD, JACKSONVILLE, FL 32225 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-20 |
| ANNUAL REPORT | 2024-01-04 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-03-18 |
| ANNUAL REPORT | 2017-07-02 |
| ANNUAL REPORT | 2016-04-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
