Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Duval
    4. ›
  4. 32216
    5. ›
  5. SOUTHEAST ORTHOPEDIC SPECIALISTS, INC.

SOUTHEAST ORTHOPEDIC SPECIALISTS, INC.

Company Details

Entity Name: SOUTHEAST ORTHOPEDIC SPECIALISTS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 07 Feb 2001 (24 years ago)
Date of dissolution: 31 Jan 2020 (5 years ago)
Last Event: CONVERSION
Event Date Filed: 31 Jan 2020 (5 years ago)
Document Number: P01000014210
FEI/EIN Number 593696338
Address: 6500 BOWDEN ROAD SUITE 103, JACKSONVILLE, FL, 32216, US
Mail Address: 6500 BOWDEN ROAD SUITE 103, JACKSONVILLE, FL, 32216, US
ZIP code: 32216
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992429039 2022-10-03 2022-10-03 6800 SOUTHPOINT PKWY STE 200, JACKSONVILLE, FL, 322166221, US 2627 RIVERSIDE AVE STE 300, JACKSONVILLE, FL, 322044717, US

Contacts
Phone +1 904-634-0640

Authorized person
Name BRETT PUCKETT
Role PRESIDENT
Phone 9046340640

Taxonomy
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHEAST ORTHOPEDIC SPECIALISTS LIFE PLAN 2018 593696338 2019-07-26 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC 225
File View Page
Three-digit plan number (PN) 513
Effective date of plan 2017-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2019-07-26
Name of individual signing SUSAN NORRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-26
Name of individual signing SUSAN NORRIS
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST ORTHOPEDIC SPECIALISTS DENTAL AND VISION PLAN 2018 593696338 2019-07-29 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC 293
File View Page
Three-digit plan number (PN) 516
Effective date of plan 2017-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing SUSAN NORRIS
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST ORTHOPEDIC SPECIALISTS LIFE PLAN 2017 593696338 2018-09-04 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC 213
File View Page
Three-digit plan number (PN) 513
Effective date of plan 2017-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2018-09-04
Name of individual signing SUSAN NORRIS
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST ORTHOPEDIC SPECIALISTS DENTAL AND VISION PLAN 2017 593696338 2018-09-04 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC 398
File View Page
Three-digit plan number (PN) 516
Effective date of plan 2017-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2018-09-04
Name of individual signing SUSAN NORRIS
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST ORTHOPEDIC SPECIALISTS HRA PLAN 2016 593696338 2017-08-30 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC 197
File View Page
Three-digit plan number (PN) 515
Effective date of plan 2016-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2017-08-30
Name of individual signing GAVAN DUFFY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-30
Name of individual signing GAVAN DUFFY
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST ORTHOPEDIC SPECIALISTS DENTAL PLAN 2016 593696338 2017-08-30 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC. 339
File View Page
Three-digit plan number (PN) 516
Effective date of plan 2016-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2017-08-30
Name of individual signing GAVAN DUFFY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-30
Name of individual signing GAVAN DUFFY
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST ORTHOPEDIC VISION PLAN 2016 593696338 2017-08-30 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC 180
File View Page
Three-digit plan number (PN) 514
Effective date of plan 2016-02-01
Business code 621111
Sponsor’s telephone number 9046340640
Plan sponsor’s mailing address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066
Plan sponsor’s address 6500 BOWDEN RD STE 103, JACKSONVILLE, FL, 322168066

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2017-08-30
Name of individual signing GAVAN DUFFY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-30
Name of individual signing GAVAN DUFFY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DONNIE ROMINE Agent 6500 BOWDEN ROAD, SUITE 103, JACKSONVILLE, FL, 32216

President

Name Role Address
PUCKETT BRETT President 6500 Bowden Road, JACKSONVILLE, FL, 32216

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000086610 SOUTHEAST ORTHOPEDIC SPECIALISTS EXPIRED 2014-08-22 2019-12-31 No data 10475 CENTURION PARKWAY, STE 220, JACKSONVILLE, FL, 32256
G14000076308 HEEKIN CENTER FOR INTEGRATED WELLNESS EXPIRED 2014-07-23 2019-12-31 No data 10475 CENTURION PARKWAY N., SUITE 220, JACKSONVILLE, FL, 32256
G13000099186 HEEKIN ORTHOPEDIC SPECIALISTS EXPIRED 2013-10-07 2018-12-31 No data 2627 RIVERSIDE AVENUE, SUITE 300, JACKSONVILLE, FL, 32204

Events

Event Type Filed Date Value Description
CONVERSION 2020-01-31 No data CONVERSION MEMBER. RESULTING CORPORATION WAS L20000052914. CONVERSION NUMBER 500000200345
REGISTERED AGENT NAME CHANGED 2017-03-16 DONNIE, ROMINE No data
CHANGE OF MAILING ADDRESS 2015-03-30 6500 BOWDEN ROAD SUITE 103, JACKSONVILLE, FL 32216 No data
CHANGE OF PRINCIPAL ADDRESS 2015-03-30 6500 BOWDEN ROAD SUITE 103, JACKSONVILLE, FL 32216 No data
AMENDMENT AND NAME CHANGE 2015-03-30 SOUTHEAST ORTHOPEDIC SPECIALISTS, INC. No data
AMENDMENT 2015-01-22 No data No data
REGISTERED AGENT ADDRESS CHANGED 2015-01-14 6500 BOWDEN ROAD, SUITE 103, JACKSONVILLE, FL 32216 No data

Documents

Name Date
ANNUAL REPORT 2019-06-13
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-16
ANNUAL REPORT 2016-03-04
ANNUAL REPORT 2015-04-22
Amendment and Name Change 2015-03-30
Amendment 2015-01-22
Reg. Agent Change 2015-01-14
ANNUAL REPORT 2014-04-15
AMENDED ANNUAL REPORT 2013-10-07

Related by officers

PUCKETT BRETT

PRL DEVELOPMENT LLC HOPCO SOUTHEAST SPECIALTY CARE NETWORK, LLC

DONNIE ROMINE

SOS REH-SR207, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated