| Entity Name: | ACE MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 03 Aug 2021 (3 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L21000350234 |
| Address: | 6428 BEACH BLVD, JACKSONVILLE, FL 32216 |
| Mail Address: | 6428 BEACH BLVD, JACKSONVILLE, FL 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710654199 | 2021-08-24 | 2021-08-24 | 6428 BEACH BLVD, JACKSONVILLE, FL, 322162813, US | 6428 BEACH BLVD, JACKSONVILLE, FL, 322162813, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-475-2039 |
| Fax | 9043300668 |
Authorized person
| Name | JOSEPH ELLYSON |
| Role | CHIEF OPERATIONS OFFICER |
| Phone | 9044752039 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| HEEKIN, JOSH | Agent | 11764 MARCO BEACH DR, SUITE 9A, JACKSONVILLE, FL 32224 |
| Name | Role | Address |
|---|---|---|
| ELLYSON, JOSEPH | Manager | 6428 BEACH BLVD, JACKSONVILLE, FL 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2021-08-03 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
