| Entity Name: | FLORIDA INJURY & REGENERATIVE MEDICINE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 May 2020 (5 years ago) |
| Document Number: | L20000120921 |
| FEI/EIN Number | 85-1041083 |
| Address: | 108 Barbados DR, PONTE VEDRA, FL, 32081, US |
| Mail Address: | 108 Barbados DR, PONTE VEDRA, FL, 32081, US |
| ZIP code: | 32081 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528680220 | 2020-05-15 | 2023-01-19 | 101 MARKETSIDE AVE # 404-777, PONTE VEDRA, FL, 320811541, US | 3033 HARTLEY RD STE 6, JACKSONVILLE, FL, 322576280, US | |||||||||||||||||||
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| Phone | +1 904-481-1111 |
| Fax | 8324423800 |
Authorized person
| Name | DR. KIRT W REPP |
| Role | MEMBER / AUTHORIZED REPRESENTATIVE |
| Phone | 2818316290 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| REPP KIRT W | Agent | 108 Barbados DR, PONTE VEDRA, FL, 32081 |
| Name | Role | Address |
|---|---|---|
| REPP KIRT W | Manager | 108 Barbados DR, PONTE VEDRA, FL, 32081 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-23 | 108 Barbados DR, PONTE VEDRA, FL 32081 | No data |
| CHANGE OF MAILING ADDRESS | 2022-08-23 | 108 Barbados DR, PONTE VEDRA, FL 32081 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-08-23 | 108 Barbados DR, PONTE VEDRA, FL 32081 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-08-23 |
| ANNUAL REPORT | 2021-02-23 |
| Florida Limited Liability | 2020-05-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
