| Entity Name: | MICHAEL STEPHENS FAMILY PRACTICE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Nov 2001 (23 years ago) |
| Document Number: | P01000112290 |
| FEI/EIN Number | 593753995 |
| Address: | 440 Kingsley Ave, ORANGE PARK, FL, 32073, US |
| Mail Address: | 440 Kingsley Ave, ORANGE PARK, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275682395 | 2007-01-09 | 2014-06-12 | 4495 ROOSEVELT BLVD, SUITE 316, JACKSONVILLE, FL, 322103375, US | 4495 ROOSEVELT BLVD, SUITE 316, JACKSONVILLE, FL, 322103375, US | |||||||||||||||
|
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| Phone | +1 904-384-5222 |
| Fax | 9043846468 |
Authorized person
| Name | DR. MICHAEL A STEPHENS |
| Role | OWNER |
| Phone | 9043845222 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| STEPHENS MICHAEL AMD | Agent | 440 Kingsley Ave, ORANGE PARK, FL, 32073 |
| Name | Role | Address |
|---|---|---|
| STEPHENS MICHAEL A | President | 440 Kingsley Ave, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2008-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
