| Entity Name: | MELCHOR M. CARBONELL, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Jan 2002 (23 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 05 Jan 2010 (15 years ago) |
| Document Number: | P02000008845 |
| FEI/EIN Number | 800032947 |
| Address: | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| Mail Address: | 7450 103RD ST, JACKSONVILLE, FL, 32210, US |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922302074 | 2011-01-04 | 2011-01-04 | 7450 103RD ST, JACKSONVILLE, FL, 322106780, US | 7450 103RD ST, JACKSONVILLE, FL, 322106780, US | |||||||||||||||||
|
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| Phone | +1 904-778-3315 |
| Fax | 9047783314 |
Authorized person
| Name | MEL CARBONELL |
| Role | PRESIDENT |
| Phone | 9047783315 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CARBONELL CATHY | Agent | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| CARBONELL MELCHOR M | President | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| CARBONELL MELCHOR M | Director | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| CARBONELL REYNALDA C | Director | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| CARBONELL STEPHEN C | Director | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| CARBONELL CATHY C | Director | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| BAI CAROLINE C | Director | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| CARBONELL STEPHEN C | Treasurer | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| CARBONELL CATHY C | Secretary | 7450 103RD ST, JACKSONVILLE, FL, 32210 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000018499 | JACKSONVILLE HEIGHTS MEDICAL SERVICES | ACTIVE | 2010-02-26 | 2025-12-31 | No data | 7450 103RD STREET, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-03-15 | 7450 103RD ST, JACKSONVILLE, FL 32210 | No data |
| CANCEL ADM DISS/REV | 2010-01-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2008-09-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| NAME CHANGE AMENDMENT | 2006-12-14 | MELCHOR M. CARBONELL, MD, PA | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-24 | CARBONELL, CATHY | No data |
| REINSTATEMENT | 2005-05-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-05-27 | 7450 103RD ST, JACKSONVILLE, FL 32210 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000552058 | LAPSED | 1000000612202 | DUVAL | 2014-04-18 | 2024-05-01 | $ 1,280.30 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| J13000171018 | TERMINATED | 1000000457525 | DUVAL | 2013-01-09 | 2023-01-16 | $ 647.17 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-09-22 |
| ANNUAL REPORT | 2022-07-22 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-04-23 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-02-02 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
