| Entity Name: | JANE LAMP, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Dec 2004 (20 years ago) |
| Document Number: | P04000167498 |
| FEI/EIN Number | 20-1999909 |
| Address: | 12957 PALMS WEST DRIVE, SUITE 104, LOXAHATCHEE, FL 33470 |
| Mail Address: | 12957 PALMS WEST DRIVE, SUITE 104, LOXAHATCHEE, FL 33470 |
| ZIP code: | 33470 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700980273 | 2006-09-12 | 2020-08-22 | 12957 PALMS WEST DR, SUITE 104, LOXAHATCHEE, FL, 334704989, US | 12957 PALMS WEST DR, SUITE 104, LOXAHATCHEE, FL, 334704989, US | |||||||||||||||||||||||||
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| Phone | +1 561-333-6033 |
| Fax | 5613336057 |
Authorized person
| Name | DR. JANE I LAMP |
| Role | PRESIDENT |
| Phone | 5613336033 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME77706 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 35758 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KAMINSKI, ROBERT | Agent | 2050 PORTLAND AVE, WELLINGTON, FL 33414 |
| Name | Role | Address |
|---|---|---|
| LAMP, JANE | Director | 2050 PORTLAND AVE, WELLINGTON, FL 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-09 | 12957 PALMS WEST DRIVE, SUITE 104, LOXAHATCHEE, FL 33470 | No data |
| CHANGE OF MAILING ADDRESS | 2007-01-09 | 12957 PALMS WEST DRIVE, SUITE 104, LOXAHATCHEE, FL 33470 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-03-18 | KAMINSKI, ROBERT | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-03-18 | 2050 PORTLAND AVE, WELLINGTON, FL 33414 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-03-11 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 29 Jan 2025
Sources: Florida Department of State
