| Entity Name: | DR. JARED GAINES MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jul 2008 (17 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P08000071591 |
| FEI/EIN Number | 263087798 |
| Address: | 1409 Kingsley avenue, ORANGE PARK, FL, 32073, US |
| Mail Address: | 1409 Kingsley avenue, ORANGE PARK, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942444757 | 2009-04-23 | 2009-11-25 | 1555 KINGSLEY AVE BLDG 300, SUITE 305, ORANGE PARK, FL, 320734560, US | 1555 KINGSLEY AVE BLDG 300, SUITE 305, ORANGE PARK, FL, 320734560, US | |||||||||||||||||||||
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| Phone | +1 352-284-4216 |
| Fax | 8666815094 |
Authorized person
| Name | JARED B GAINES |
| Role | OWNER |
| Phone | 3522844216 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RR MEDICARE |
| Number | P00760459 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GAINES JARED | Agent | 1133 WEST KESLEY LANE, SAINT JOHNS, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| GAINES JARED | Officer | 1133 WEST KESLEY LANE, SAINT JOHNS, FL, 32259 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000105463 | NORTH FLORIDA FAMILY PSYCHIATRY | EXPIRED | 2009-05-08 | 2014-12-31 | No data | 1555 KINGSLEY AVE, UNIT 305, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-12 | 1133 WEST KESLEY LANE, SAINT JOHNS, FL 32259 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-23 | 1409 Kingsley avenue, Suite 9D, ORANGE PARK, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2013-01-23 | 1409 Kingsley avenue, Suite 9D, ORANGE PARK, FL 32073 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-05-08 | GAINES, JARED | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-02-12 |
| ANNUAL REPORT | 2013-01-23 |
| ANNUAL REPORT | 2012-02-09 |
| ANNUAL REPORT | 2011-02-22 |
| ANNUAL REPORT | 2010-06-24 |
| ANNUAL REPORT | 2009-05-08 |
| Domestic Profit | 2008-07-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
