| Entity Name: | DUNN AVENUE HEALTH AND WELLNESS CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Jul 2009 (15 years ago) |
| Date of dissolution: | 29 Apr 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Apr 2016 (9 years ago) |
| Document Number: | P09000063669 |
| FEI/EIN Number | 270556483 |
| Address: | 3450 DUNN AVE, 302, JACKSONVILLE, FL, 32218 |
| Mail Address: | 3450 DUNN AVE, 302, JACKSONVILLE, FL, 32218 |
| ZIP code: | 32218 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528396058 | 2009-11-20 | 2010-06-10 | 3450 DUNN AVE, STE. 302, JACKSONVILLE, FL, 322186426, US | 3450 DUNN AVE, STE. 302, JACKSONVILLE, FL, 322186426, US | |||||||||||||||||||||||||
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| Phone | +1 904-329-1904 |
| Fax | 9043291905 |
Authorized person
| Name | DR. EDWARD WILLIAMS JR. |
| Role | PHYSICIAN/OWNER |
| Phone | 9043291904 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS 6019 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 45366300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH GERALDINE W | Agent | 3450 DUNN AVE, JACKSONVILLE, FL, 32218 |
| Name | Role | Address |
|---|---|---|
| SMITH KAREN ESTELLA | President | 3450 DUNN AVENUE STE 302, JACKSONVILLE, FL, 32218 |
| SMITH GERALDINE W | President | 3450 DUNN AVENUE STE 302, JACKSONVILLE,, FL, 32218 |
| Name | Role | Address |
|---|---|---|
| SMITH KAREN ESTELLA | Director | 3450 DUNN AVENUE STE 302, JACKSONVILLE, FL, 32218 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-04-29 | No data | No data |
| REINSTATEMENT | 2014-10-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| PENDING REINSTATEMENT | 2012-02-16 | No data | No data |
| REINSTATEMENT | 2012-02-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2012-02-16 | SMITH, GERALDINE W | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2016-04-29 |
| ANNUAL REPORT | 2015-04-30 |
| REINSTATEMENT | 2014-10-10 |
| ANNUAL REPORT | 2013-03-26 |
| REINSTATEMENT | 2012-02-16 |
| Domestic Profit | 2009-07-27 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
