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ORTHOTIC & PROSTHETIC CLINIC OF JACKSONVILLE, LLC - Florida Company Profile

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Company Details

Entity Name: ORTHOTIC & PROSTHETIC CLINIC OF JACKSONVILLE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 17 Nov 2023 (2 years ago)
Document Number: L23000518765
FEI/EIN Number 93-4505579
Address: 11512 Lake Mead Ave, Jacksonville, FL, 32256, US
Mail Address: 2754 NW 27TH AVE, BOCA RATON, FL, 33434, US
ZIP code: 32256
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
DIAZ ABREU RAFAEL AGUSTIN Authorized Member 2754 NW 27TH AVE, BOCA RATON, FL, 33434
JIMENEZ LUBRANO ROBERTO J Authorized Member 2754 NW 27TH AVE, BOCA RATON, FL, 33434
DIAZ ABREU RAFAEL AGUSTIN Agent 2754 NW 27TH AVE, BOCA RATON, FL, 33434

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
RAFAEL DIAZ ABREU
User ID:
P3356256
Trade Name:
ORTHOTIC & PROSTHETIC CLINICS OF AMERICA

Unique Entity ID

Unique Entity ID:
VP8GNJA267E8
CAGE Code:
0QAA6
UEI Expiration Date:
2025-12-20

Business Information

Doing Business As:
ORTHOTIC & PROSTHETIC CLINICS OF AMERICA
Activation Date:
2024-12-29
Initial Registration Date:
2024-12-20

Commercial and government entity program

CAGE number:
0QAA6
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-12-29
CAGE Expiration:
2029-12-29
SAM Expiration:
2025-12-20

Contact Information

POC:
RAFAEL A. DIAZ ABREU
Corporate URL:
https://opclinicsamerica.com/

National Provider Identifier

NPI Number:
1942067939
Certification Date:
2024-03-05

Authorized Person:

Name:
MR. RAFAEL AGUSTIN DIAZ ABREU
Role:
OWNER / AMBR
Phone:

Taxonomy:

Selected Taxonomy:
335E00000X - Prosthetic/Orthotic Supplier
Is Primary:
No
Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
Yes

Contacts:

Fax:
9042318441

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000037701 ORTHOTIC & PROSTHETIC CLINICS OF AMERICA ACTIVE 2024-03-14 2029-12-31 - 2754 NW 27TH AVE, BOCA RATON, FL, 33434

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-24 11512 Lake Mead Ave, Unit 404, Jacksonville, FL 32256 -

Documents

Name Date
ANNUAL REPORT 2024-04-24
Florida Limited Liability 2023-11-17

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Date of last update: 02 Aug 2025

Sources: Florida Department of State