| Entity Name: | KAIROS PSYCHIATRY PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Apr 2020 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Feb 2024 (a year ago) |
| Document Number: | L20000186225 |
| FEI/EIN Number | 84-2914072 |
| Address: | 4105 Crownwood Drive, JACKSONVILLE, FL, 32216, US |
| Mail Address: | 4105 Crownwood Drive, JACKSONVILLE, FL, 32216, US |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902435589 | 2020-04-05 | 2021-09-08 | 10950 SAN JOSE BLVD # 60-213, JACKSONVILLE, FL, 322236688, US | 4105 CROWNWOOD DR, JACKSONVILLE, FL, 322163610, US | |||||||||||||||
|
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| Phone | +1 352-339-8013 |
| Phone | +1 206-486-0424 |
Authorized person
| Name | HAULEK TAWMGING |
| Role | OWNER |
| Phone | 2064860424 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TAWMGING SANNU | Agent | 2922 INDIAN SPRINGS LN, JACKSONVILLE, FL, 32303 |
| Name | Role | Address |
|---|---|---|
| TAWMGING HAULEK | Authorized Member | 4105 Crownwood Drive, JACKSONVILLE, FL, 32216 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000120613 | HT LLC | ACTIVE | 2022-09-23 | 2027-12-31 | No data | 4105 CROWNWOOD DRIVE, JACKSONVIILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-02-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-02-02 | TAWMGING, SANNU | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-23 | 4105 Crownwood Drive, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF MAILING ADDRESS | 2022-09-23 | 4105 Crownwood Drive, JACKSONVILLE, FL 32216 | No data |
| CONVERSION | 2020-04-27 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS. CONVERSION NUMBER 900000204069 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-02-02 |
| ANNUAL REPORT | 2022-09-23 |
| ANNUAL REPORT | 2021-09-08 |
| Florida Limited Liability | 2020-04-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
