| Entity Name: | JACKSONVILLE ORAL SURGERY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Nov 2019 (5 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 25 Apr 2024 (9 months ago) |
| Document Number: | L19000280656 |
| FEI/EIN Number | 84-3813833 |
| Mail Address: | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| Address: | 2047 PARK STREET, JACKSONVILLE, FL, 32204 |
| ZIP code: | 32204 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871123984 | 2020-01-17 | 2020-01-17 | 2047 PARK ST, JACKSONVILLE, FL, 322043809, US | 2047 PARK ST, JACKSONVILLE, FL, 322043809, US | |||||||||||||
|
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| Phone | +1 904-388-7665 |
Authorized person
| Name | MIKE COLE |
| Role | VP INSURANCE PLAN MANAGEMENT |
| Phone | 4195531509 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| GALLO DONALD A | Manager | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2024-04-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-25 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-25 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-24 |
| CORLCRACHG | 2024-04-25 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-29 |
| Florida Limited Liability | 2019-11-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
