| Entity Name: | JACKSON MEDICAL ENTERPRISE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 25 Apr 2016 (9 years ago) |
| Date of dissolution: | 20 Nov 2018 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Nov 2018 (6 years ago) |
| Document Number: | L16000080526 |
| FEI/EIN Number | 81-2507639 |
| Address: | 2263 CAMPESTRE TERRACE, NAPLES, FL 34119 |
| Mail Address: | 2263 CAMPESTRE TERRACE, NAPLES, FL 34119 |
| ZIP code: | 34119 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023463429 | 2016-05-04 | 2016-05-04 | 2263 CAMPESTRE TER, NAPLES, FL, 341193358, US | 4800 ASTON GARDENS WAY, MEDICAL DIRECTOR'S OFFICE, NAPLES, FL, 341093501, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 239-207-0948 |
| Phone | +1 239-330-1301 |
Authorized person
| Name | MALIA M JACKSON RODRIGUEZ |
| Role | OWNER |
| Phone | 2392070948 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME 104632 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | ME 104632 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | ME 104632 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JACKSON RODRIGUEZ, MALIA M, MD | Agent | 2263 CAMPESTRE TERRACE, NAPLES, FL 34119 |
| Name | Role | Address |
|---|---|---|
| JACKSON RODRIGUEZ, MALIA M | Manager | 2263 CAMPESTRE TERRACE, NAPLES, FL 34119 |
| Name | Role | Address |
|---|---|---|
| Pandy, Sunil | Chief Operating Officer | 2263 CAMPESTRE TERRACE, NAPLES, FL 34119 |
| Name | Role | Address |
|---|---|---|
| Larson, Elizabeth | Vice President | 2263 CAMPESTRE TERRACE, NAPLES, FL 34119 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-11-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-02-26 | JACKSON RODRIGUEZ, MALIA M, MD | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2018-11-20 |
| ANNUAL REPORT | 2018-02-26 |
| ANNUAL REPORT | 2017-05-02 |
| Florida Limited Liability | 2016-04-25 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
