| Entity Name: | NORTH FLORIDA ADDICTION MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Aug 2001 (23 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 30 Aug 2024 (5 months ago) |
| Document Number: | P01000085090 |
| FEI/EIN Number | 651146420 |
| Address: | 642 S Military Trl, Deerfield Beach, FL, 33442, US |
| Mail Address: | 642 S Military Trl, Deerfield Beach, FL, 33442, US |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447306410 | 2007-01-25 | 2014-12-01 | 1100 PARK CENTRAL BLVD S, SUITE 3400, POMPANO BEACH, FL, 330642218, US | 1900 CORPORATE SQUARE BLVD, JACKSONVILLE, FL, 322161941, US | |||||||||||||||||||
|
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| Phone | +1 954-691-0856 |
| Fax | 9546910834 |
Authorized person
| Name | DONNA A CAMPBELL |
| Role | DIRECTOR BILLING/COLLECTIONS |
| Phone | 9546910856 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 8000-27017 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Johnson Phillip C | Agent | 1200 S PINE ISLAND RD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Kircher III Robert E | Chairman | 642 S Military Trl, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Stevens Jamie | Chief Executive Officer | 642 S Military Trl, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Johnson Phillip C | Chief Financial Officer | 642 S Military TRL, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Leong Franklin | Vice Chairman | 642 S Military Trl, Deerfield Beach, FL, 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2024-08-30 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 0. MERGER NUMBER 300000257953 |
| REGISTERED AGENT NAME CHANGED | 2023-03-13 | Johnson, Phillip Clay | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-20 | 642 S Military Trl, Deerfield Beach, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-20 | 642 S Military Trl, Deerfield Beach, FL 33442 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-12-20 | 1200 S PINE ISLAND RD, PLANTATION, FL 33324 | No data |
| AMENDMENT | 2016-12-20 | No data | No data |
| NAME CHANGE AMENDMENT | 2004-02-03 | NORTH FLORIDA ADDICTION MEDICINE, INC. | No data |
| AMENDMENT AND NAME CHANGE | 2004-02-02 | NORTH AMERICAN ADDICTION MEDICINE, INC. | No data |
| Name | Date |
|---|---|
| Merger | 2024-08-30 |
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-03-09 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-01-31 |
| ANNUAL REPORT | 2017-03-21 |
| Amendment | 2016-12-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
