| Entity Name: | MY CHOICE OPERATING COMPANY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jan 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 21 May 2021 (4 years ago) |
| Document Number: | L21000007374 |
| FEI/EIN Number | 86-1377080 |
| Address: | 4655 Salisbury Road, JACKSONVILLE, FL, 32256, US |
| Mail Address: | 4655 SALISBURY ROAD, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174112007 | 2021-01-14 | 2023-12-27 | 4655 SALISBURY RD STE 110, JACKSONVILLE, FL, 322560957, US | 4655 SALISBURY RD STE 220, JACKSONVILLE, FL, 322560959, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-733-1003 |
| Phone | +1 904-570-9404 |
| Fax | 9049002224 |
Authorized person
| Name | MR. ROBERT G YOUNG |
| Role | SECRETARY & CAO |
| Phone | 9047331003 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | CLIA |
| Number | 10D2178878 |
| State | FL |
| Issuer | AHCA |
| Number | 12550 |
| State | FL |
| Issuer | MEDICAID |
| Number | 110526700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YOUNG ROBERT G | Agent | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| RUCKER DAVID C | Chief Executive Officer | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| FISHER JEFFREY L | President | 4655 SALISBURY ROAD, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| YOUNG ROBERT G | Secretary | 4655 SALISBURY ROAD, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| Young Robert G | Chief Financial Officer | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| MC FLORIDA ACQUISITIONCO 1, LLC | Member | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL, 32256 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000034749 | COMMUNITY MEDICAL | ACTIVE | 2022-03-17 | 2027-12-31 | No data | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL, 32256 |
| G21000172858 | MOBILE MEDICAL | ACTIVE | 2021-12-29 | 2026-12-31 | No data | 4655 SALISBURY ROAD, SUITE 110, JACKSONVILLE, FL, 32256 |
| G21000015648 | MY CHOICE | ACTIVE | 2021-02-02 | 2026-12-31 | No data | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-10 | 4655 Salisbury Road, Suite 220, JACKSONVILLE, FL 32256 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-08-05 | 4655 SALISBURY ROAD, STE. 110, JACKSONVILLE, FL 32256 | No data |
| LC AMENDMENT | 2021-05-21 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-11-13 |
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2022-02-10 |
| Reg. Agent Change | 2021-08-23 |
| LC Amendment | 2021-05-21 |
| Florida Limited Liability | 2021-01-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
