Search icon

KETAMINE WELLNESS INSTITUTE OF JACKSONVILLE BEACH LLC - Florida Company Profile

Company Details

Entity Name: KETAMINE WELLNESS INSTITUTE OF JACKSONVILLE BEACH LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

KETAMINE WELLNESS INSTITUTE OF JACKSONVILLE BEACH LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 14 Jan 2022 (3 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 08 Sep 2022 (3 years ago)
Document Number: L22000029840
FEI/EIN Number 87-4686472

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1361 13TH AVE S, SUITE 140, JACKSONVILLE BEACH, FL, 32250, US
Mail Address: 1361 13TH AVE S, SUITE 140, JACKSONVILLE BEACH, FL, 32250, US
ZIP code: 32250
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1487471918 2024-09-25 2024-09-25 1361 13TH AVE S STE 140, JACKSONVILLE BEACH, FL, 322503263, US 1361 13TH AVE S STE 140, JACKSONVILLE BEACH, FL, 322503263, US

Contacts

Phone +1 904-373-8153

Authorized person

Name SATHAVARAM REDDY
Role OWNER
Phone 9043738153

Taxonomy

Taxonomy Code 208VP0014X - Interventional Pain Medicine Physician
Is Primary Yes

Key Officers & Management

Name Role Address
REDDY SATHAVARAM A Managing Member 164 PINEHURST POINTE DRIVE, ST. AUGUSTINE, FL, 32092
THE LAW OFFICES OF STEPHEN F. DIFATO PLLC Agent 164 PINEHURST POINTE DRIVE, ST. AUGUSTINE, FL, 32092

Events

Event Type Filed Date Value Description
LC AMENDMENT 2022-09-08 - -
CHANGE OF PRINCIPAL ADDRESS 2022-09-08 1361 13TH AVE S, SUITE 140, JACKSONVILLE BEACH, FL 32250 -
CHANGE OF MAILING ADDRESS 2022-09-08 1361 13TH AVE S, SUITE 140, JACKSONVILLE BEACH, FL 32250 -

Documents

Name Date
ANNUAL REPORT 2024-01-18
ANNUAL REPORT 2023-03-11
LC Amendment 2022-09-08
Florida Limited Liability 2022-01-14

Date of last update: 01 Apr 2025

Sources: Florida Department of State