| Entity Name: | JACKSONVILLE ACCIDENT AND SPORTS INJURY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 26 Jun 2017 (8 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L17000138470 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 6353-1 Argyle Forrest Blvd., Jacksonville, FL, 32244, US |
| Mail Address: | 9044 SE BRIDGE RD., HOBE SOUND, 33455, UN |
| ZIP code: | 32244 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922523166 | 2017-08-09 | 2017-08-09 | 8929 SE BRIDGE RD, HOBE SOUND, FL, 334555312, US | 4235 SUNBEAM RD, JACKSONVILLE, FL, 322576013, US | |||||||||||||||||||||
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| Phone | +1 772-546-9591 |
| Fax | 7725469535 |
Authorized person
| Name | JENEANE WAKULA |
| Role | OFFICE MANAGER |
| Phone | 7725469591 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CHIROPRACTIC LICENSE |
| Number | CH0007334 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WAKULA JENEANE | Agent | 9044 SE Bridge Rd., HOBE SOUND, FL, 33455 |
| Name | Role | Address |
|---|---|---|
| MAHALO LLC | Member | No data |
| Salameh Joseph | Member | 1724 Village Way, Orange Park, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-07-31 | 6353-1 Argyle Forrest Blvd., Suite B, Jacksonville, FL 32244 | No data |
| CHANGE OF MAILING ADDRESS | 2020-01-21 | 6353-1 Argyle Forrest Blvd., Suite B, Jacksonville, FL 32244 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-21 | 9044 SE Bridge Rd., HOBE SOUND, FL 33455 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-07-31 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| Florida Limited Liability | 2017-06-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
