| Entity Name: | D.C. DEWEESE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 27 Feb 2002 (23 years ago) |
| Document Number: | P02000024208 |
| FEI/EIN Number | 04-3642417 |
| Address: | 1312 DUNN AVE, JACKSONVILLE, FL 32218 |
| Mail Address: | 1312 DUNN AVE, JACKSONVILLE, FL 32218 |
| ZIP code: | 32218 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972797579 | 2007-08-28 | 2014-03-19 | 1312 DUNN AVE, JACKSONVILLE, FL, 322184836, US | 1312 DUNN AVE, JACKSONVILLE, FL, 322184836, US | |||||||||||||||||||||||||
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| Phone | +1 904-757-4786 |
| Fax | 9047574882 |
Authorized person
| Name | DR. DAMON CHRIS DEWEESE |
| Role | DOCTOR |
| Phone | 9047574786 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8089 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381586200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JONES, TERRANCE A | Agent | 769 BLANDING BLVD., ORANGE PARK, FL 32065 |
| Name | Role | Address |
|---|---|---|
| DEWEESE, DAMON C | Director | 1312 DUNN AVENUE, JACKSONVILLE, FL 32218 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-01 | 1312 DUNN AVE, JACKSONVILLE, FL 32218 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-01 | 1312 DUNN AVE, JACKSONVILLE, FL 32218 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-01-27 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-03-02 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
