| Entity Name: | JSPEELE, MD, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Jan 2013 (12 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P13000000914 |
| FEI/EIN Number | 46-1671869 |
| Address: | 7380 SAND LAKE ROAD, SUITE 500, ORLANDO, FL, 32819 |
| Mail Address: | PO BOX 1189, WINDERMERE, FL, 34786 |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548507908 | 2013-01-05 | 2013-01-05 | 7380 W SAND LAKE RD, SUITE 500, ORLANDO, FL, 328195248, US | 7380 W SAND LAKE RD, SUITE 500, ORLANDO, FL, 328195248, US | |||||||||||||||||||||||||||||||
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| Phone | +1 407-929-5611 |
| Fax | 8882539194 |
Authorized person
| Name | DR. JEFFREY S PEELE |
| Role | PRESIDENT |
| Phone | 4079295611 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | ME61635 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS |
| Number | 43697 |
| State | FL |
| Issuer | MEDICAID |
| Number | 254676100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEELE JEFFREY S | Agent | 3349 KING GEORGE DRIVE, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| PEELE JEFFREY S | President | 3349 KING GEORGE DRIVE, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| PEELE LISA M | Vice President | 3349 KING GEORGE DRIVE, ORLANDO, FL, 32835 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-02-28 |
| ANNUAL REPORT | 2014-03-22 |
| Domestic Profit | 2013-01-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
