| Entity Name: | CARTE BLANCHE HOLDINGS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Dec 2014 (10 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: | P14000098094 |
| FEI/EIN Number | 47-2495002 |
| Address: | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| Mail Address: | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| ZIP code: | 32206 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558730085 | 2015-09-15 | 2015-09-15 | 1626 N LIBERTY ST, JACKSONVILLE, FL, 322064649, US | 13546 BEACH BLVD, UNIT 2, JACKSONVILLE, FL, 322247232, US | |||||||||||||||||||||||||||
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| Phone | +1 904-625-0038 |
| Phone | +1 904-574-5000 |
Authorized person
| Name | MR. BLAKE A KOZOL |
| Role | PRESIDENT |
| Phone | 9046250038 |
Taxonomy
| Taxonomy Code | 207QB0002X - Obesity Medicine (Family Medicine) Physician |
| License Number | ME42368 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RB0002X - Obesity Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207VB0002X - Obesity Medicine (Obstetrics & Gynecology) Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARTE BLANCHE HOLDINGS, INC. 401(K) PROFIT SHARING | 2016 | 472495002 | 2017-05-17 | CARTE BLANCHE HOLDINGS, INC. | 1 | |||||||||||||||||||
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| Active participants | 0 |
| Number of participants with account balances as of the end of the plan year | 0 |
| Name | Role | Address |
|---|---|---|
| KOZOL, BLAKE | Agent | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| Name | Role | Address |
|---|---|---|
| KOZOL, BLAKE | President | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| Name | Role | Address |
|---|---|---|
| KOZOL, BLAKE | Secretary | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| Name | Role | Address |
|---|---|---|
| KOZOL, BLAKE | Treasurer | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| Name | Role | Address |
|---|---|---|
| KOZOL, BLAKE | Director | 1626 N LIBERTY STREET, JACKSONVILLE, FL 32206 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000124167 | CBHI | EXPIRED | 2015-12-09 | 2020-12-31 | No data | 1626 N LIBERTY ST, JACKSONVILLE, FL, 32206 |
| G15000018694 | MEDI-WEIGHTLOSS | EXPIRED | 2015-02-20 | 2020-12-31 | No data | 1626 NORTH LIBERTY ST, JACKSONVILLE, FL, 32206 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-18 |
| ANNUAL REPORT | 2015-03-04 |
| Domestic Profit | 2014-12-08 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
