| Entity Name: | JAX'S FAMILY CARE & RESEARCH CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Dec 2003 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 22 Jul 2009 (16 years ago) |
| Document Number: | P04000005789 |
| FEI/EIN Number | 753148738 |
| Address: | 5233 RICKER RD, SUITE 101, JACKSONVILLE, FL, 32210 |
| Mail Address: | PO Box 17723, JACKSONVILLE, FL, 32245, US |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275704710 | 2008-03-12 | 2018-07-11 | 5233 RICKER RD STE 101, JACKSONVILLE, FL, 322101439, US | 5233 RICKER RD STE 101, JACKSONVILLE, FL, 32210, US | |||||||||||||||||||||||||
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| Phone | +1 904-800-2332 |
| Fax | 9046347892 |
Authorized person
| Name | JAIRO ANTONIO DELAHOZ JR. |
| Role | MANAGER |
| Phone | 9048002332 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | ME70797 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 251739600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DE LA HOZ JAIRO | Agent | 5233 RICKER RD, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| De La Hoz Jairo | President | 5233 RICKER RD, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| De La Hoz Jairo Jr. | Vice President | 5233 Ricker Rd Suite 101, Jacksonville, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-01-15 | 5233 RICKER RD, SUITE 101, JACKSONVILLE, FL 32210 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-04 | 5233 RICKER RD, SUITE 101, JACKSONVILLE, FL 32210 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-05 | DE LA HOZ, JAIRO | No data |
| REINSTATEMENT | 2009-07-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-02-12 | 5233 RICKER RD, SUITE 101, JACKSONVILLE, FL 32210 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-01-19 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
