| Entity Name: | DME DC PROVIDER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 05 Apr 2018 (7 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L18000086959 |
| FEI/EIN Number | 82-5237283 |
| Address: | 12641 SAN JOSE BLVD, JACKSONVILLE, FL 32223 |
| Mail Address: | 848 BUCKEYE LANE WEST, ST JOHNS, FL 32259 |
| ZIP code: | 32223 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295228039 | 2018-06-06 | 2018-06-06 | 848 BUCKEYE LN W, SAINT JOHNS, FL, 322594387, US | 12641 SAN JOSE BLVD, JACKSONVILLE, FL, 322232646, US | |||||||||||||||||||||
|
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| Phone | +1 904-477-6644 |
| Phone | +1 904-606-6007 |
| Fax | 9043768738 |
Authorized person
| Name | DR. NATHALIE BLUM |
| Role | OWNER |
| Phone | 9044776644 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH9429 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NATHALIE BLUM | Agent | 848 BUCKEYE LANE WEST, ST JOHNS, FL 32259 |
| Name | Role | Address |
|---|---|---|
| NATHALIE BLUM | MMMM | 848 BUCKEYE LANE WEST, ST JOHNS, FL 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-06-08 | 12641 SAN JOSE BLVD, JACKSONVILLE, FL 32223 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-29 |
| Florida Limited Liability | 2018-04-05 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
