| Entity Name: | BEST REST SLEEP CENTERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Mar 2005 (20 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | P05000047710 |
| FEI/EIN Number | 861135480 |
| Address: | 1515 PRUDENTIAL DR, SUITE 1001, JACKSONVILLE, FL, 32207, US |
| Mail Address: | P.O. BOX 11165, JACKSONVILLE, FL, 32239, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831115112 | 2006-07-13 | 2020-08-22 | PO BOX 11165, JACKSONVILLE, FL, 322391165, US | 1515 PRUDENTIAL DR, SUITE 1001, JACKSONVILLE, FL, 322078133, US | |||||||||||||||||||||||||||||||
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| Phone | +1 904-858-1909 |
| Fax | 9048581911 |
Authorized person
| Name | MR. RICH CHRISTOPHERSON |
| Role | CFO |
| Phone | 9048581909 |
Taxonomy
| Taxonomy Code | 261QS1200X - Sleep Disorder Diagnostic Clinic/Center |
| License Number | HCC6849 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER ID |
| Number | V2990 |
| State | FL |
| Issuer | AVMED ID |
| Number | 302003 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HUSEMAN WILLIAM R | Agent | 3733 UNIVERSITY BLVD. WEST, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| SHOUVLIN THOMAS P | Director | 1603 HARRINGTON PARK DR., JACKSONVILLE, FL, 32225 |
| ADEEB BARRY | Director | 501 ATLANTIC BLVD., ATLANTIC BEACH, FL, 32233 |
| BURNSED DON | Director | 11803 DON BURNSED RD, SANDERSON, FL, 32087 |
| SORRESSO DENNIS | Director | 1375 SOUTHSHORE DR, ORANGE PARK, FL, 32003 |
| CHRISTOPHERSON RICHARD | Director | 11435 CR 125 N, GLEN ST MARY, FL, 32040 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| AMENDMENT | 2006-10-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-05-01 | 1515 PRUDENTIAL DR, SUITE 1001, JACKSONVILLE, FL 32207 | No data |
| CHANGE OF MAILING ADDRESS | 2006-05-01 | 1515 PRUDENTIAL DR, SUITE 1001, JACKSONVILLE, FL 32207 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-04-30 |
| Amendment | 2006-10-04 |
| ANNUAL REPORT | 2006-05-01 |
| Domestic Profit | 2005-03-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
