| Entity Name: | ALINA M. GALLIANO-PARDO, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Feb 2011 (14 years ago) |
| Document Number: | P11000012249 |
| FEI/EIN Number | 274781265 |
| Address: | 4141 SOUTHPOINT DR E, SUITE A, JACKSONVILLE, FL, 32216, US |
| Mail Address: | PO BOX 51507, JACKSONVILLE BEACH, FL, 32240, US |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235423989 | 2011-05-30 | 2022-07-08 | PO BOX 51507, JACKSONVILLE BEACH, FL, 322401507, US | 4141 SOUTHPOINT DR E STE A, JACKSONVILLE, FL, 322168061, US | |||||||||||||||||||||||||||
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| Phone | +1 904-853-5900 |
| Fax | 9048535885 |
| Phone | +1 904-853-9000 |
Authorized person
| Name | DR. ALINA MARIA GALLIANO-PARDO |
| Role | OWNER |
| Phone | 9048535900 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0802X - Addiction Psychiatry Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003427500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KETTERINGHAM BARNEY B | Agent | 4141 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| GALLIANO-PARDO ALINA MDr. | Director | 4141 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| KETTERINGHAM BARNEY B | Director | 4141 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| GALLIANO-PARDO ALINA MDr. | President | 4141 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| KETTERINGHAM BARNEY B | Secretary | 4141 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| KETTERINGHAM BARNEY B | Treasurer | 4141 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-20 | 4141 SOUTHPOINT DR E, SUITE A, JACKSONVILLE, FL 32216 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-20 | 4141 SOUTHPOINT DR E, SUITE A, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-03 | 4141 SOUTHPOINT DR E, SUITE A, JACKSONVILLE, FL 32216 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-05-08 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-02-21 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
